Pull-through medical device

• US 9,308,359 B2
• Filed: 05/25/2005
• Issued: 04/12/2016
• Est. Priority Date: 05/25/2005
• Status: Active Grant

• Current Assignee: Boston Scientific Scimed (Boston Scientific Corporation)
• Original Assignee: Boston Scientific Scimed (Boston Scientific Corporation)
• Inventors: Ward, Tim
• Primary Examiner(s): Sweet, Thomas J
• Assistant Examiner(s): MILLER, CHERYL L
• Application Number:
  US11/136,500
• Publication Number:
  US 20060271202A1
• Time in Patent Office: 3,975 Days
• Field of Search: 623/1.1, 623/1.11, 623/1.12, 623/1.15, 623/1.16, 623/1.23, 623/23.66, 623/23.7, 623/23.64, 600/585, 604/164.13
• US Class Current: 1/1
• CPC Class Codes: A61F 2002/048 Ureters
• CPC Class Codes: A61F 2002/9505 having retaining means other than an outer sleeve, e.g. male-female connector between stent and instrument
• CPC Class Codes: A61M 2025/09125 Device for locking a guide wire in a fixed position with respect to the catheter or the human body
• CPC Class Codes: A61M 25/0045 multi-layered, e.g. coated coating materials A61L29/08
• CPC Class Codes: A61M 25/007 Side holes, e.g. their profiles or arrangements; Provisions to keep side holes unblocked
• CPC Class Codes: A61M 25/0102 Insertion or introduction using an inner stiffening member, e.g. stylet or push-rod
• CPC Class Codes: A61M 25/0105 Steering means as part of the catheter or advancing means; Markers for positioning systems for detection of markers A61B
• CPC Class Codes: A61M 25/09 Guide wires
• CPC Class Codes: A61M 27/008 pre-shaped, for use in the urethral or ureteral tract

Abstract

A ureteral stent assembly includes a ureteral stent having a distal end portion, a proximal end portion, and a medial end portion. The ureteral stent assembly also includes an elongate positioner for positioning the ureteral stent within the body of the patient. The positioner includes a distal end portion, a proximal end portion, and a medial end portion. A coupling mechanism configured to removably or releasably couple the ureteral stent to the elongate positioner is located on at least one of the distal end portion of the ureteral stent, the medial portion of the ureteral stent, the distal end portion of the positioner, and the medial portion of the positioner. In one embodiment, the ureteral stent includes a lumen that is configured to receive the positioner, and the positioner includes a lumen that is configured to receive a guidewire. In such an embodiment, the guidewire is configured such that when the positioner is disposed within the lumen of the ureteral stent and the guidewire is disposed within the lumen of the positioner, the coupling mechanism is actuated to removably or releasably couple the positioner to the ureteral stent. In one embodiment, the coupling mechanism is a two portion coupling mechanism. In such an embodiment, one portion of the coupling mechanism is located on each of the ureteral stent and the elongate positioner.

Claims

1. A ureteral stent assembly comprising:

a ureteral stent having a distal end portion for placement in a kidney of a patient, a proximal end portion opposite the distal end portion, and a medial portion located between the distal end portion and the proximal end portion, the ureteral stent having a sidewall, the sidewall having an inner surface and outer surface, the inner surface of the sidewall defining a lumen between the distal end portion of the ureteral stent and the proximal end portion of the ureteral stent, the sidewall on the distal end portion of the ureteral stent defining an opening that extends from the inner surface to the outer surface,

the opening defining a first portion of a coupling mechanism, the proximal end portion being configured to be placed in at least one of a ureter of the patient, a bladder of the patient, and outside of a body of the patient, the distal end portion of the ureteral stent having a retention member, the retention member having a first configuration and a second configuration, the retention member being non-linear and configured to help retain the distal end portion of the ureteral stent in place within the kidney of the patient when the retention member is in the second configuration;

an elongate positioner for positioning the ureteral stent in the ureter, the elongate positioner having a distal end portion for insertion into at least one of the kidney of the patient and the ureter of the patient, a proximal end portion for placement outside of the body of the patient, and a medial portion located between the distal end portion of the elongate positioner and the proximal end portion of the elongate positioner,

the distal end portion of the elongate positioner having a second portion of the coupling mechanism coupled to the first portion of the coupling mechanism when the elongate positioner is in a first position, at least a portion of the elongate positioner being disposed within the lumen of the ureteral stent when in the first position, the second portion of the coupling mechanism at least partially extending into the opening from the inner surface of the sidewall of the ureteral stent when in the first position, the second portion of the coupling mechanism being disposed within the lumen defined by the ureteral stent and uncoupled from the first portion of the coupling mechanism when the elongate positioner is in a second position, the elongate positioner includes a lumen; and

a guidewire for insertion into the lumen of the elongate positioner, the coupling mechanism being configured such that the elongate positioner and the ureteral stent are coupled together in response to the guidewire being inserted into the lumen of the elongate positioner and advanced distally within the lumen of the ureteral stent, the coupling mechanism being configured such that the elongate positioner and the ureteral stent are decoupled in response to the guidewire being removed from the lumen of the elongate positioner by proximal advancement from inside the lumen of the ureteral stent.

2. The assembly of claim 1, wherein the second portion of the coupling mechanism is configured to flex into the opening of the ureteral stent when in the first position.

3. The assembly of claim 1, wherein the elongate positioner includes a sidewall having an inner surface, the inner surface of the sidewall of the elongate positioner defining the lumen of the elongate positioner, the second portion of the coupling mechanism being bendable such that portions of the inner surface of the sidewall of the elongate positioner move towards each other when moving from the first position to the second position.

4. The assembly of claim 1, wherein the second portion of the coupling mechanism includes a deflectable projection, the deflectable projection being at least partially inserted into the opening of the ureteral stent when in the first position.

5. The assembly of claim 1, wherein the second portion of the coupling mechanism is engaged with the first portion of the coupling mechanism when the elongate positioner is in the first position, the second portion of the coupling mechanism being disengaged from the first portion of the coupling mechanism when the elongate positioner is in the second position.

6. The assembly of claim 1, wherein the second portion of the coupling mechanism includes a bendable portion, the bendable portion having a projection that extends away from a sidewall defined by the elongate positioner, the projection being at least partially disposed within the opening of the ureteral stent when the elongate positioner is in the first position, the projection being disposed outside the opening of the ureteral stent when the elongate positioner is in the second position.

7. The assembly of claim 6, wherein the bendable portion having the projection flexes when the elongate positioner is moved between the first position and the second position.

8. The assembly of claim 6, wherein the projection extends in a direction substantially orthogonal to a longitudinal axis defined by the elongate positioner when the elongate positioner is in the first position.

9. The assembly of claim 1, wherein the lumen of the elongate positioner extends from the distal end portion of the elongate positioner to the proximal end portion of the elongate positioner, wherein

the guidewire is configured to extend within the lumen of the elongate positioner from the proximal end portion of the elongate positioner to the distal end portion of the elongate positioner,

the elongate positioner being in the first position when at least a portion of the guidewire is disposed within at least a portion of the lumen of the elongate positioner.

10. The assembly of claim 1, wherein the opening of the ureteral stent includes a first opening defined by the sidewall of the ureteral stent on a first location and a second opening defined by the sidewall of the ureteral stent on a second location, the second portion of the coupling mechanism includes a first bendable portion having a first projection and a second bendable portion having a second projection, the first projection at least partially extending into the first opening when in the first position, the second projection at least partially extending into the second opening when in the first position.

11. The assembly of claim 1, wherein a position of the elongate positioner with respect to the ureteral stent is substantially fixed when the elongate positioner is in the first position, the elongate positioner being able to move with respect to the ureteral stent when the elongate positioner is in the second position.

12. An assembly, comprising:

a ureteral stent having a first end portion, a second end portion opposite the first end portion, and a medial portion located between the first end portion and the second end portion, the first end portion of the ureteral stent being configured to be placed within a kidney of a patient, at least a portion of the medial portion being configured to be placed within a ureter of the patient, the ureteral stent having a sidewall, the sidewall having an inner surface and outer surface, the inner surface of the sidewall defining a lumen, the sidewall defining an opening that extends from the inner surface to the outer surface, the opening defining a first portion of a coupling mechanism, the first end portion of the ureteral stent having a retention member, the retention member having a first configuration and a second configuration, the retention member being non-linear and configured to help retain the first end portion of the ureteral stent in place within the kidney of the patient when the retention member is in the second configuration;

an elongate positioner configured to position the ureteral stent within the body, the elongate positioner having a first portion and a second portion, the elongate positioner having a second portion of the coupling mechanism coupled to the first portion of the coupling mechanism when the elongate positioner is in a first position, the second portion of the coupling mechanism at least partially extending into the opening from the inner surface of the sidewall of the ureteral stent when in the first position, the second portion of the coupling mechanism being disposed within the lumen defined by the ureteral stent and out of the opening of the ureteral stent when the elongate positioner is in a second position;

the first end portion of the ureteral stent being disposed adjacent the first portion of the elongate positioner when the elongate positioner is in the first position, the second end portion of the ureteral stent being disposed adjacent the second portion of the elongate positioner when the elongate positioner is in the first position,

wherein the elongate positioner includes a sidewall having an inner surface, the inner surface of the sidewall of the elongate positioner defining a lumen, the second portion of the coupling mechanism being bendable such that portions of the inner surface of the sidewall of the elongate positioner move towards each other when moving from the first position to the second position; and

a guidewire for insertion into the lumen of the elongate positioner, the coupling mechanism being configured such that the elongate positioner and the ureteral stent are coupled together in response to the guidewire being inserted into the lumen of the elongate positioner and advanced distally wherein the lumen of the ureteral stent, the coupling mechanism being configured such that the elongate positioner and the ureteral stent are decoupled in response to the guidewire being removed from the lumen of the elongate positioner by proximal advancement from inside the lumen of the ureteral stent.

13. The assembly of claim 12, wherein the second portion of the coupling mechanism includes a bendable portion defined by the sidewall of the elongate positioner, the bendable portion having a projection, the bendable portion configured to flex into the opening of the ureteral stent when in the first position.

14. The assembly of claim 12, wherein the coupling mechanism has an engaged configuration and a disengaged configuration.

15. The assembly of claim 12, wherein the elongate positioner is in the first position when the guidewire is disposed within the lumen of the elongate positioner, the elongate positioner being in the second position when the guidewire is disposed outside the lumen of the elongate positioner.

16. The assembly of claim 12, wherein the lumen of the elongate positioner extends from a distal end portion of the elongate positioner to a proximal end portion of the elongate positioner, the second portion of the coupling mechanism having a projection, the projection being disposed within the opening of the ureteral stent when the elongate positioner is in the first position, the projection being disposed outside the opening of the ureteral stent when the elongate positioner is in the second position.

17. The assembly of claim 16, wherein the projection extends in a direction substantially orthogonal to a longitudinal axis defined by the elongate positioner when the elongate positioner is in the first position.

18. The assembly of claim 12, wherein the lumen of the elongate positioner extends from a distal end portion of the elongate positioner to a proximal end portion of the elongate positioner, the second portion of the coupling mechanism having a projection having an extended configuration and a retracted configuration, the projection being in its extended configuration when the guide wire is positioned within the distal end portion of the elongate positioner.

19. A ureteral stent assembly comprising:

a ureteral stent having a distal end portion for placement in a kidney of a patient, a proximal end portion opposite the distal end portion, and a medial portion located between the distal end portion and the proximal end portion, the ureteral stent having a sidewall, the sidewall having an inner surface and outer surface, the inner surface of the sidewall defining a lumen between the distal end portion of the ureteral stent and the proximal end portion of the ureteral stent, the sidewall on the distal end portion of the ureteral stent defining an opening that extends from the inner surface to the outer surface, the opening defining a first portion of a coupling mechanism, the proximal end portion being configured to be placed in at least one of a ureter of the patient, a bladder of the patient, and outside of a body of the patient, the distal end portion of the ureteral stent having a retention member, the retention member having a first configuration and a second configuration, the retention member being non-linear and configured to help retain the distal end portion of the ureteral stent in place within the kidney of the patient when the retention member is in its second configuration;

an elongate positioner for positioning the ureteral stent in a ureter, the elongate positioner having a distal end portion for insertion into at least one of the kidney of the patient and the ureter of the patient, a proximal end portion for placement outside of the body of the patient, and a medial portion located between the distal end portion of the elongate positioner and the proximal end portion of the elongate positioner, the distal end portion of the elongate positioner having a second portion of the coupling mechanism coupled to the first portion of the coupling mechanism when the elongate positioner is in a first position, at least a portion of the elongate positioner being disposed within the lumen of the ureteral stent when in the first position, the second portion of the coupling mechanism at least partially extending into the opening from the inner surface of the sidewall of the ureteral stent when in the first position, the second portion of the coupling mechanism being disposed within the lumen defined by the ureteral stent and uncoupled from the first portion of the coupling mechanism when the elongate positioner is in a second position,

wherein the elongate positioner defines a lumen extending from the proximal end portion of the elongate positioner to the distal end portion of the elongate positioner, the elongate positioner including a body portion, the second portion of the coupling mechanism extending from the body portion, the second portion of the coupling mechanism being configured to move with respect to the body portion between an extended position and a retracted position and being biased toward the retracted position; and

a guidewire configured to extend within the lumen of the elongate positioner from the proximal end portion of the elongate positioner to the distal end portion of the elongate positioner, the guidewire urging the second portion of the coupling mechanism to the extended position such that the second portion of the coupling mechanism at least partially extends within the opening of the ureteral stent when at least a portion of the guidewire is disposed within at least a portion of the lumen of the elongate positioner,

the coupling mechanism being configured such that the elongate positioner and the ureteral stent are coupled together in response to the guidewire being inserted into the lumen of the elongate positioner and advanced distally wherein the lumen of the ureteral stent, the coupling mechanism being configured such that the elongate positioner and the ureteral stent are decoupled in response to the guidewire being removed from the lumen of the elongate positioner by proximal advancement from inside the lumen of the ureteral stent.

20. A ureteral stent assembly comprising:

a ureteral stent having a distal end portion for placement in a kidney of a patient, a proximal end portion opposite the distal end portion, and a medial portion located between the distal end portion and the proximal end portion, the ureteral stent defining a lumen between the distal end portion of the ureteral stent and the proximal end portion of the ureteral stent, the distal end portion of the ureteral stent defining a through-hole through a sidewall of the ureteral stent, the through-hole defining a first portion of a coupling mechanism, the proximal end portion being configured to be placed in at least one of a ureter of the patient, a bladder of the patient, and outside of a body of the patient, the distal end portion of the ureteral stent having a retention member, the retention member having a first configuration and a second configuration, the retention member being non-linear and configured to help retain the distal end portion of the ureteral stent in place within a kidney of the patient when the retention member is in its second configuration;

an elongate positioner for positioning the ureteral stent in a ureter, the elongate positioner having a distal end portion for insertion into at least one of the kidney of the patient and the ureter of the patient, a proximal end portion for placement outside of the body of the patient, and a medial portion located between the distal end portion of the elongate positioner and the proximal end portion of the elongate positioner, the elongate positioner having a sidewall, the sidewall having an inner surface defining a lumen extending from the proximal end portion of the elongate positioner to the distal end portion of the elongate positioner, the distal end portion of the elongate positioner having a second portion of the coupling mechanism coupled to the first portion of the coupling mechanism when the elongate positioner is in a first position, the second portion of the coupling mechanism including a bendable portion having a projection, the bendable portion being defined by the sidewall of the elongate positioner, the projection extending away from an outer surface of the sidewall of the elongate positioner, the elongate positioner disposed within the lumen of the ureteral stent between the distal end portion of the ureteral stent and the proximal end portion of the ureteral stent when in the first position, the second portion of the coupling mechanism being uncoupled from the first portion of the coupling mechanism when the elongate positioner is in a second position, the second portion of the coupling mechanism being configured to move between an extended position and a retracted position and being biased toward the retracted position; and

a guidewire configured to extend within the lumen of the elongate positioner from the proximal end portion of the elongate positioner to the distal end portion of the elongate positioner, the guidewire urging the second portion of the coupling mechanism to the extended position such that the projection at least partially extends within the through-hole of the ureteral stent when at least a portion of the guidewire is disposed within at least a portion of the lumen of the elongate positioner,

the coupling mechanism being configured such that the elongate positioner and the ureteral stent are coupled together in response to the guidewire being inserted into the lumen of the elongate positioner and advanced distally wherein the lumen of the ureteral stent, the coupling mechanism being configured such that the elongate positioner and the ureteral stent are decoupled in response to the guidewire being removed from the lumen of the elongate positioner by proximal advancement from inside the lumen of the ureteral stent.

21. The assembly of claim 20, wherein the through-hole of the ureteral stent includes a first through-hole defined by the sidewall of the ureteral stent at a first location and a second through-hole defined by the sidewall of the ureteral stent at a second location, the bendable portion having the projection including a first bendable portion having a first projection and a second bendable portion having a second projection, the first projection at least partially extending into the first through-hole in the extended position, the second projection at least partially extending into the second through-hole in the extended position.