Luminal stenting

• US 9,192,498 B2
• Filed: 09/30/2013
• Issued: 11/24/2015
• Est. Priority Date: 02/23/2012
• Status: Active Grant

• Current Assignee: Covidien LP (Medtronic Plc)
• Original Assignee: Covidien LP (Medtronic Plc)
• Inventors: Newell, Gabriel, Huynh, Andy, Farhat, Lawrence
• Primary Examiner(s): MILES, JONATHAN WADE
• Application Number:
  US14/042,423
• Publication Number:
  US 20140031918A1
• Time in Patent Office: 785 Days
• US Class Current: 1/1
• CPC Class Codes: A61F 2/82 Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents stent-grafts for tubular structures of the body other than blood vessels A61F2/04; stent-grafts for blood vessels A61F2/07; instruments specially adapted for placement or removal of stents or stent-grafts A61F2/95; for closing wounds, or holding wounds closed A61B17/04 - A61B17/115; dilators A61M29/00
• CPC Class Codes: A61F 2/95 Instruments specially adapted for placement or removal of stents or stent-grafts
• CPC Class Codes: A61F 2/9522 Means for mounting a stent or stent-graft onto or into a placement instrument
• CPC Class Codes: A61F 2/966 with relative longitudinal movement between outer sleeve and prosthesis, e.g. using a push rod
• CPC Class Codes: A61F 2/97 the outer sleeve being splittable
• CPC Class Codes: A61F 2002/9534 for repositioning of stents
• CPC Class Codes: A61F 2002/9665 with additional retaining means

Abstract

A stent delivery system, a core assembly, and methods of operating the same are provided. The delivery system can comprise a catheter and the core assembly. The core assembly can comprise a constraining member, protruding member, a core member, and a stent extending along the core member. The tubular constraining member can be spaced apart from the core member and define a capture area. The protruding member can be disposed along the core member at least partially distal of the capture area. The stent can have a first portion disposed within the capture area and a second portion, distal to the first portion, extending across or over an outer surface of the protruding member so that the protruding member and the constraining member cooperate to inhibit expansion of the first portion of the stent.

Claims

1. A method of operating a stent delivery system within a vessel of a patient, comprising:

positioning a catheter in the vessel, the catheter having a lumen defining an axis extending between a proximal end and a distal end, such that the catheter distal end is at a treatment site;

positioning a core assembly within the catheter lumen, the core assembly having (i) an elongate member comprising a distal section, (ii) a stent having a distal portion and being carried along the elongate member, and (iii) a distal cover coupled to the member distal section and extending proximally, the core assembly being positioned within the lumen such that the elongate member distal section is positioned axially adjacent the catheter distal end with at least a portion of the distal cover extending in a space within the lumen radially between the elongate member distal section and the catheter distal end;

distally advancing the core assembly relative to the catheter to permit expansion of the stent distal portion, the expansion urging the distal cover away from the elongate member; and

proximally withdrawing the core assembly into the catheter such that the elongate member distal section is positioned axially adjacent to the catheter distal end with the distal cover positioned out of the space and extending distally.

2. The method of claim 1, wherein during proximal withdrawal of the core assembly into the catheter, the distal cover is positioned out of the space to provide a clearance between the elongate member and the catheter.

3. The method of claim 1, further comprising releasing the stent at the treatment site within the vessel.

4. The method of claim 3, further comprising proximally withdrawing the core assembly from the lumen while maintaining the catheter distal end in place at the treatment site.

5. The method of claim 4, further comprising inserting a second core assembly into the lumen, the second core assembly being configured to deliver a second stent at the treatment site.

6. The method of claim 1, wherein proximally withdrawing the core assembly comprises everting a free first end of the distal cover from a proximally oriented position to a distally oriented position.

7. The method of claim 6, wherein the distal cover is coupled to the core assembly at a distal cover second end, the first end being positioned distally relative to the second end when the distal cover is everted.

8. The method of claim 1, wherein the core assembly comprises an elongate member, and wherein the advancing comprises rotating the elongate member relative to the stent.

9. The method of claim 1, wherein the advancing comprises frictionally engaging a proximal end of the stent.

10. A method of operating a stent delivery system within a blood vessel of a patient, comprising:

positioning a catheter in the vessel, the catheter having a lumen extending between a proximal end and a distal end, such that the catheter distal end is at a treatment site;

advancing a core assembly distally within the catheter, the core assembly having (i) a distal section, (ii) a distal cover extending from the distal section, and (iii) a stent having a distal portion and being carried by the core assembly, the core assembly being advanced within the catheter such that the distal cover extends proximally from the distal section;

distally advancing the core assembly relative to the catheter to permit expansion of the stent distal portion, the expansion urging the distal cover radially away from the core assembly; and

proximally withdrawing the core assembly into the catheter such that the distal cover extends distally through an annular space between the distal section and the catheter.

11. The method of claim 10, wherein during proximal withdrawal of the core assembly into the catheter, the distal cover extends distally through the annular space to provide a clearance between the catheter and an intermediate portion of the core assembly proximal to the distal cover.

12. The method of claim 10, wherein proximally withdrawing the core assembly comprises everting a free first end of the distal cover from a proximally oriented position to a distally oriented position.

13. The method of claim 12, wherein the distal cover is coupled to the core assembly at a distal cover second end, the first end being positioned distally relative to the second end when the distal cover is everted.

14. The method of claim 10, wherein the core assembly comprise an elongate member, and wherein distally advancing comprises rotating the elongate member relative to the stent.

15. The method of claim 10, wherein the advancing comprises frictionally engaging a proximal end of the stent.

16. A method of operating a stent delivery system within a vessel of a patient, comprising:

positioning a catheter in the vessel, the catheter having a lumen defining an axis extending between a proximal end and a distal end, such that the catheter distal end is at a treatment site;

positioning a core assembly within the catheter lumen, the core assembly having (i) an elongate member comprising a distal section, (ii) a self-expanding stent having a distal portion and being carried by the elongate member, and (iii) a distal cover having first and second ends, the first end coupled to the member distal section, the second end extending proximally from the member distal section to be radially interposed between the catheter and the stent distal portion without exerting a substantial radial constraining force on the stent; and

distally advancing the core assembly relative to the catheter to permit expansion of the stent distal portion thereby causing the second end of the distal cover to move radially without substantially constricting stent expansion and permitting movement of the second end distally beyond the first end.

17. The method of claim 16, wherein the distally advancing comprises permitting the stent to self-expand such that an expansive force of the stent moves the distal cover absent another expansive force.

18. The method of claim 16, wherein the advancing comprises rotating the elongate member relative to the stent.

19. The method of claim 16, wherein the distal cover comprises an elongate flexible material, the method further comprising proximally withdrawing the core assembly to evert the distal cover, such that the second end moves from a first configuration, in which the second end is located proximally relative to the first end, to a second configuration, in which the second end is located distally relative to the first end.

20. The method of claim 16, wherein the advancing comprises frictionally engaging a proximal end of the stent.