Apparatus and methods for improved stent deployment

• US 9,192,497 B2
• Filed: 09/04/2009
• Issued: 11/24/2015
• Est. Priority Date: 09/05/2008
• Status: Active Grant

• Current Assignee: Cook Medical Incorporated (Cook Group Incorporated)
• Original Assignee: Cook Medical Incorporated (Cook Group Incorporated)
• Inventors: Haselby, Kenneth
• Primary Examiner(s): Rodjom, Katherine
• Assistant Examiner(s): HOLLM, JONATHAN A
• Application Number:
  US13/062,429
• Publication Number:
  US 20110178588A1
• Time in Patent Office: 2,272 Days
• Field of Search: 606/108, 606/191, 606/198, 623/1.11, 623/1.12, 623/1.13, 623/1.14, 623/1.23, 623/2.11
• US Class Current: 1/1
• CPC Class Codes: A61F 2/915 with bands having a meander structure, adjacent bands being connected to each other
• CPC Class Codes: A61F 2/95 Instruments specially adapted for placement or removal of stents or stent-grafts
• CPC Class Codes: A61F 2/9661 the proximal portion of the stent or stent-graft is released first
• CPC Class Codes: A61F 2002/91591 Locking connectors, e.g. using male-female connections
• CPC Class Codes: A61F 2002/9511 the retaining means being filaments or wires
• CPC Class Codes: A61F 2002/9534 for repositioning of stents
• CPC Class Codes: A61F 2002/9665 with additional retaining means
• CPC Class Codes: A61F 2220/0016 with sharp anchoring protrusions, e.g. barbs, pins, spikes
• CPC Class Codes: A61F 2220/0058 soldered or brazed or welded
• CPC Class Codes: A61F 2220/0075 sutured, ligatured or stitched, retained or tied with a rope, string, thread, wire or cable
• CPC Class Codes: A61F 2230/0013 Horseshoe-shaped, e.g. crescent-shaped, C-shaped, U-shaped

Abstract

Apparatus for facilitating deployment of a an implantable medical device includes a control member (20) having at least one tine member (35-37). A proximal region (35b-37b) of at least one of the tine members (35-37) is configured to engage an associated portion of a stent (60). In use, the control member (20) comprises a contracted delivery configuration in which the proximal region of the at least one of the tine member (35-37) is radially contracted, to radially constrain the associated portion of the stent (60). The control member (20) also comprises an expanded configuration in which the proximal region of the at least one of the tine member (35-37) expands radially outward relative to the central longitudinal axis to allow the stent to engage a body passage.

Claims

1. An apparatus for deploying a stent, the apparatus comprising:

a control member having at least one tine member comprising proximal and distal regions, where the proximal region of the at least one tine member is configured to engage an associated portion of a stent,

a sheath at least partially disposed over the at least one tine member in a constrained state,

where the control member comprises a contracted delivery configuration in which the proximal region of the at least one tine member is radially contracted and an expanded configuration in which the proximal region of the at least one of the tine member is radially expanded relative to a central longitudinal axis,

where the proximal region of the at least one tine member is selectively and incrementally movable between the contracted and expanded configurations to facilitate positioning of the stent within a body passage,

where the proximal region of the at least one tine member has a bend towards the central longitudinal axis in a state unconstrained by the sheath,

where the proximal region of the at least one tine member comprises a first width and a first length, and the distal region of the at least one tine member comprises a second width greater than the first width and a second length greater than the first length, such that a stepped portion is formed between the proximal and distal regions of the at least one tine member.

2. The apparatus of claim 1 further comprising an outer cannula having a lumen, where the outer cannula is sized for longitudinal movement over a portion of the distal region of the at least one tine member, where selective proximal advancement of the outer cannula over the distal region of the at least one tine member is configured to incrementally urge the proximal region of the at least one tine member in a radially inward direction relative to the central longitudinal axis.

3. The apparatus of claim 2 where selective distal retraction of the outer cannula over the distal region of the at least one tine member is configured to permit incremental radial expansion of the proximal region of the at least one tine members relative to the central longitudinal axis.

4. The apparatus of claim 2 further comprising:

an inner cannula having proximal and distal ends, where the inner cannula comprises a lumen disposed between the proximal and distal ends to permit advancement of the inner cannula over a wire guide,

where a distal region of the control member is affixed to an outer surface of the inner cannula, and

where the outer cannula is sized for longitudinal advancement over the inner cannula.

5. The apparatus of claim 4, further comprising an atraumatic tip disposed on the proximal end of the inner cannula, where the atraumatic tip comprises a distal end having an inner recess, and where the proximal region of the at least one tine member is disposed within the inner recess during delivery of the stent into the body passage.

6. The apparatus of claim 1 where the control member comprises:

a plurality of tine members; and

a cannula having at least one slit formed into the cannula,

where the at least one slit is disposed between adjacent tine members.

7. The apparatus of claim 6 where the cannula comprises a shape memory alloy.

8. The apparatus of claim 1 where the proximal region of the at least one tine member is sized to be advanced through an associated portion of a stent.

9. A method for deploying a stent, the method comprising:

providing a control member having at least one tine member comprising proximal and distal regions;

providing a sheath at least partially disposed over the at least one tine member in a constrained state;

coupling the proximal region of the at least one tine member to an associated portion of a stent without an external wire;

advancing the control member into a body passage in a contracted delivery configuration in which the proximal region of the at least one tine member is radially contracted relative to a central longitudinal axis of the control member to radially constrain the associated portion of the stent;

deploying the control member to an expanded configuration in which the proximal region of the at least one tine member expands radially outward relative to the central longitudinal axis to allow the stent to expand, and further where the proximal region of the at least one tine member has a bend towards the central longitudinal axis in a state unconstrained by the sheath; and

selectively and incrementally moving the proximal region of the at least one tine member between the contracted and expanded configurations to facilitate positioning of the stent,

wherein the proximal region of the at least one tine member comprises a first width and a first length, and the distal region of the at least one tine member comprises a second width greater than the first width and a second length greater than the first length, such that a stepped portion is formed between the proximal and distal regions of the at least one tine member.

10. The method of claim 9 further comprising:

contracting the at least one tine member;

repositioning the stent; and

allowing the at least one tine member to expand to permit expansion of the stent.

11. The method of claim 10 further comprising proximally advancing an outer cannula over the distal region of the at least one tine member to incrementally urge the proximal region of the at least one tine member in a radially inward direction relative to the central longitudinal axis.

12. The method of claim 11 further comprising incrementally distally retracting the outer cannula over the distal region of the at least one tine member to permit incremental radial expansion of the proximal region of the at least one tine members relative to the central longitudinal axis.

13. The method of claim 10 where the proximal region of the at least one tine member comprises a first width, and the distal region of the at least one tine member comprises a second width, where the first width is less than the second width to form a stepped portion between the proximal and distal regions of the at least one tine member, the method further comprising:

advancing the proximal region of the tine member through a bore of the stent; and

abutting the stepped portion against the stent to substantially inhibit distal movement of the stent with respect to the control member when the at least one tine member is coupled to the stent.

14. An apparatus for deploying a stent, the apparatus comprising:

a control member having at least one tine member comprising proximal and distal regions, where the proximal region of the at least one tine member is configured to engage an associated portion of a stent,

where the control member comprises a contracted delivery configuration in which the proximal region of the at least one tine member is radially contracted and an expanded configuration in which the proximal region of the at least one of the tine member is radially expanded relative to a central longitudinal axis,

where the proximal region of the at least one tine member is selectively and incrementally movable between the contracted and expanded configurations to facilitate positioning of the stent within a body passage,

where the proximal region of the at least one tine member comprises a first width, and the distal region of the at least one tine member comprises a second width greater than the first width, such that a stepped portion is formed between the proximal and distal regions of the at least one tine member,

where the proximal region of the at least one tine member has a bend towards the central longitudinal axis, and

wherein the bend is disposed in the proximal region of the first width.

15. The apparatus of claim 14 further comprising an outer cannula having a lumen, where the outer cannula is sized for longitudinal movement over a portion of the distal region of the at least one tine member, where selective proximal advancement of the outer cannula over the distal region of the at least one tine member is configured to incrementally urge the proximal region of the at least one tine member in a radially inward direction relative to the central longitudinal axis.

16. The apparatus of claim 15 where selective distal retraction of the outer cannula over the distal region of the at least one tine member is configured to permit incremental radial expansion of the proximal region of the at least one tine members relative to the central longitudinal axis.

17. The apparatus of claim 15 further comprising:

an inner cannula having proximal and distal ends, where the inner cannula comprises a lumen disposed between the proximal and distal ends to permit advancement of the inner cannula over a wire guide,

where a distal region of the control member is affixed to an outer surface of the inner cannula, and

where the outer cannula is sized for longitudinal advancement over the inner cannula.

18. The apparatus of claim 17, further comprising an atraumatic tip disposed on the proximal end of the inner cannula, where the atraumatic tip comprises a distal end having an inner recess, and where the proximal region of the at least one tine member is disposed within the inner recess during delivery of the stent into the body passage.

19. The apparatus of claim 14 where the control member comprises:

a plurality of tine members; and

a cannula having at least one slit formed into the cannula,

where the at least one slit is disposed between adjacent tine members.