Devices for stent advancement
First Claim
Patent Images
1. A device comprising:
- an outer sheath;
a stent disposed within the outer sheath, the stent having a distal end and a proximal end;
a stent-engaging element positioned at least partially within a lumen of the stent; and
a stent-retention element configured to contact the proximal end of the stent;
a handle coupled to the outer sheath such that the outer sheath cannot move relative to the handle;
a user-actuatable element movable along the handle, the user-actuatable element being coupled to the stent-engaging element;
a stopper biased to a first position that restricts distal advancement of the user-actuatable element, the stopper comprising a passageway, wherein the stopper has a second position that allows the user-actuatable element to pass through the passageway;
wherein the device is configured such that;
the stent-engaging element is configured to operate in a reciprocating manner to engage and advance the stent distally at least partially out of the outer sheath; and
the stent-retention element will stay in contact with the stent during proximal movement of the stent-engaging element provided that the proximal end of the stent is disposed within the outer sheath and will cease contact when the proximal end of the stent is advanced outside of the outer sheath.
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Abstract
Devices and methods for stent advancement, including methods for instructing another or others how to advance a stent into an anatomical structure or into a testing/demonstration synthetic structure, such as a polymer tube. The advancement may be achieved by at least two periods of stent engagement that drive a stent distally from a sheath separated by a period of non-engagement.
678 Citations
75 Claims
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1. A device comprising:
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an outer sheath; a stent disposed within the outer sheath, the stent having a distal end and a proximal end; a stent-engaging element positioned at least partially within a lumen of the stent; and a stent-retention element configured to contact the proximal end of the stent; a handle coupled to the outer sheath such that the outer sheath cannot move relative to the handle; a user-actuatable element movable along the handle, the user-actuatable element being coupled to the stent-engaging element; a stopper biased to a first position that restricts distal advancement of the user-actuatable element, the stopper comprising a passageway, wherein the stopper has a second position that allows the user-actuatable element to pass through the passageway; wherein the device is configured such that; the stent-engaging element is configured to operate in a reciprocating manner to engage and advance the stent distally at least partially out of the outer sheath; and the stent-retention element will stay in contact with the stent during proximal movement of the stent-engaging element provided that the proximal end of the stent is disposed within the outer sheath and will cease contact when the proximal end of the stent is advanced outside of the outer sheath. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12)
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13. A device comprising:
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an outer sheath; a handle coupled to the outer sheath such that the outer sheath cannot move relative to the handle, the handle having a proximal end and a user-actuatable element constrained by a length of a slot; a stent disposed within the outer sheath, the stent having a distal end and a proximal end; a stent-engaging element coupled to the user-actuatable element and configured to engage the stent between the distal and proximal ends of the stent; and a stopper comprising a passageway, the stopper biased to a first position that restricts distal advancement of the user-actuatable element, wherein the stopper has a second position that allows the user-actuatable element to pass through the passageway to travel a full length of the slot, wherein distal and proximal movement of the user-actuatable element advances the stent distally out of the outer sheath through multiple engagements of the stent by the stent-engaging element, wherein each engagement occurs between the proximal and distal ends of the stent, wherein distal movement of the user-actuatable element drives the stent distally without a mechanized concomitant withdrawal of the outer sheath, and wherein proximal movement of the user-actuatable element does not drive the stent distally; and the user'"'"'s proximal-most point of contact with the device that causes each engagement is located at or distal of the proximal end of the handle. - View Dependent Claims (14, 15, 16, 17, 18, 19, 20, 21, 22)
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23. A device comprising:
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an outer sheath; a handle coupled to the outer sheath such that the outer sheath cannot move relative to the handle, the handle having a proximal end; a stent disposed within the outer sheath, the stent having a lumen, a distal end and a proximal end; a stent-engaging element positioned at least partially within the lumen of the stent, the stent-engaging element shaped like a shovel and configured to engage two intersections on opposing sides of the stent when driving the stent distally; a user-actuatable element slidable along a slot of the handle; and a stopper biased to a first position that restricts distal advancement of the user-actuatable element, the stopper comprising a passageway, the user-actuatable element movable along a portion of the slot when the stopper is in the first position, the portion less than a full length of the slot, and movable along the full length of the slot and through the passageway when the stopper is in a second position, where the device is configured such that; a user can advance the stent distally out of the outer sheath through at least two periods of engagement of the stent by the stent-engaging element that drive the stent distally and that are separated by a period of non-engagement that does not drive the stent distally; and the user'"'"'s proximal-most point of contact with the device that causes each period of engagement is located at or distal of the proximal end of the handle. - View Dependent Claims (24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34)
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35. A device comprising:
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an outer sheath; a stent disposed within the outer sheath, the stent having a lumen, a distal end and a proximal end; an inner element positioned at least partially within the lumen of the stent, the inner element being configured to accept a guidewire; and a stent-engaging element separate from the inner element and positioned at least partially within the lumen of the stent; a handle coupled to the outer sheath such that the outer sheath cannot move relative to the handle; a user-actuatable element movable along the handle, the user-actuatable element being coupled to the stent-engaging element; a stopper biased to a first position that restricts distal advancement of the user-actuatable element, the stopper comprising a passageway, wherein the stopper has a second position that allows the user-actuatable element to pass through the passageway; wherein the device is configured to distally drive the stent at least partially out of the outer sheath through at least two periods of engagement of the stent by the stent-engaging element that are separated by a period of non-engagement that does not drive the stent distally. - View Dependent Claims (36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47)
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48. A stent advancement method comprising:
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distally driving a stent out of a sheath and into a tubular structure by engaging the stent between its distal and proximal ends with a stent-engaging element a multiple number of engagements, wherein the multiple number of engagements are separated by a period of non-engagement, and wherein during each of the multiple number of engagements, the stent-engaging element moves from a first position to a second position distal to the first position; and engaging the stent at its proximal end with a stent-retention element that is positioned within the sheath, wherein an operator accomplishes the driving of the stent by moving a user-actuatable element with the operator'"'"'s thumb, wherein the user-actuatable element is constrained by a traversable length of a slot, and wherein moving a stopper from a first position to a second position to a second position changes the traversable length of the slot. - View Dependent Claims (49, 50, 51, 52, 53, 54, 55, 56, 57, 58, 59)
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60. A device comprising:
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an outer sheath; a handle coupled to the outer sheath, the outer sheath being stationary relative to the handle, the handle including a user-actuatable element coupled to a pusher, the user-actuatable element movable along a slot of the handle; a stopper comprising a passageway, the stopper rotatable from a first position in which the passageway is not aligned with the slot to a second position in which the passageway is aligned with the slot; a stent disposed within the outer sheath; and a stent-engaging element disposed within the outer sheath and coupled to the pusher; wherein the stent is distally driveable out of the outer sheath through at least two periods of engagement of the stent by the stent-engaging element, each said period of engagement configured to drive the stent distally without a mechanized concomitant withdrawal of the outer sheath and each said period of engagement separated by a period of non-engagement of the stent by the stent-engaging element that is configured to not drive the stent distally. - View Dependent Claims (61, 62, 63, 64, 65, 66, 67, 68, 69)
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70. A stent advancement method comprising:
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moving a user-actuatable element from a first position in a slot of a handle to a second position in the slot of the handle, the user-actuatable element coupled to a stent-engaging element, wherein during moving the user-actuatable element from the first position to the second position, the stent-engaging element engages a stent between distal and proximal ends of the stent to distally drive a first portion of the stent out of a sheath while a second portion of the stent remains within the sheath; after moving the user-actuatable element from the first position to the second position, moving the user-actuatable element from the second position to the first position, wherein during moving the user-actuatable element from the second position to the first position, the stent-engaging element folds inwardly and slides proximally within the stent; after moving the user-actuatable element from the second position to the first position, second moving the user-actuatable element from the first position to the second position, wherein during second moving the user-actuatable element from the first position to the second position, the stent-engaging element engages the stent between the distal and proximal ends of the stent to drive the second portion of the stent at least partially out of the sheath; after second moving the user-actuatable element from the first position to the second position, rotating a stopper to increase a traversable length of the slot of the handle by the user-actuatable element; and moving the user-actuatable element to a third position distal to the second position, wherein during moving the user-actuatable element to the third position, the stent-engaging element extends out of the sheath. - View Dependent Claims (71, 72, 73, 74, 75)
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Specification