Vascular graft device placement methods

• US 9,463,104 B2
• Filed: 06/06/2014
• Issued: 10/11/2016
• Est. Priority Date: 06/07/2013
• Status: Active Grant

• Current Assignee: Cedars-Sinai Medical Center (Cedars Sinai Health System)
• Original Assignee: Cedars-Sinai Medical Center (Cedars Sinai Health System)
• Inventors: Siegel, Robert James, Marzelle, Jean
• Primary Examiner(s): Miles, Jonathan
• Assistant Examiner(s): OBU, KENDRA NNEAMAKA
• Application Number:
  US14/896,095
• Publication Number:
  US 20160120673A1
• Time in Patent Office: 858 Days
• US Class Current: 1/1
• CPC Class Codes: A61B 17/12109 in a blood vessel
• CPC Class Codes: A61B 17/12118 for positioning in conjunction with a stent
• CPC Class Codes: A61B 2017/1205 Introduction devices
• CPC Class Codes: A61F 2/07 Stent-grafts
• CPC Class Codes: A61F 2/95 Instruments specially adapted for placement or removal of stents or stent-grafts
• CPC Class Codes: A61F 2/954 for placing stents or stent-grafts in a bifurcation
• CPC Class Codes: A61F 2/958 Inflatable balloons for placing stents or stent-grafts
• 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 2002/9528 for retrieval of stents
• CPC Class Codes: A61F 2002/9623 the sleeve being reinforced
• CPC Class Codes: A61M 2025/0197 for creating an artificial passage within the body, e.g. in order to go around occlusions
• CPC Class Codes: A61M 25/0194 Tunnelling catheters
• CPC Class Codes: A61M 60/00 Blood pumps; Devices for mechanical circulatory actuation; Balloon pumps for circulatory assistance heart stimulation A61H31/00; heart stimulators for electrotherapy A61N1/362
• CPC Class Codes: A61M 60/122 Implantable pumps or pumping devices, i.e. the blood being pumped inside the patient's body

Abstract

In another embodiment, a method is provided for positioning a graft device in an ascending aorta of a patient. In the method, access is provided to a peripheral venous site. A first catheter is advanced through the peripheral venous site to a right atrium of the patient. Access is provided to the left atrium across an intra-atrial septum. The first catheter is advanced through to a left atrium of a patient. A second catheter is advanced from the first catheter through a left ventricle and the aorta to a peripheral arterial site. A graft device disposed on, over or within the second catheter is advanced from the peripheral venous site or the peripheral arterial site until the graft device reaches an ascending aorta of the patient. The graft device is positioned at a treatment site within the ascending aorta. The first and second catheters are removed from the patient.

Claims

1. A method for positioning a device in a blood vessel of a patient adjacent to the heart, the method comprising

advancing a venous catheter endoluminally from a venous site to the heart;

advancing an elongate member from the venous catheter through a valve in the heart to a blood vessel adjacent to the heart;

advancing an arterial catheter endoluminally from an arterial site toward the heart;

drawing the elongate member into the arterial catheter;

advancing the arterial catheter over the elongate member such that tip portions of the venous and arterial catheters are brought into adjacency; and

deploying a device within the blood vessel from a platform extending from the venous catheter to the arterial site, the blood vessel being adjacent to the heart.

2. The method of claim 1, wherein the elongate member comprises a flow directed device.

3. The method of claim 1, further comprising positioning the tip portions adjacent to but spaced away from each other.

4. The method of claim 1, further comprising coupling the tip portions with each other.

5. The method of claim 1, wherein the elongate body comprises a flow directed catheter.

6. The method of claim 5, wherein drawing the elongate body into the arterial catheter comprises extending a snare from the tip portion of the arterial catheter and capturing the flow directed catheter with the snare.

7. The method of claim 1, wherein the elongate member comprises a snare.

8. The method of claim 1, wherein the arterial site is located at a peripheral superficial blood vessel.

9. The method of claim 1, wherein the arterial site is disposed in a brachial artery.

10. The method of claim 1, wherein the arterial site is disposed in an axillary artery.

11. The method of claim 1, wherein the arterial site is disposed in a subclavian artery.

12. The method of claim 1, wherein the arterial site is a common carotid artery.

13. The method of claim 1, wherein deploying a device comprises:

advancing a graft device disposed on, over or within the platform to a position within a aorta of the patient;

positioning the graft device at a treatment site within the aorta; and

expanding the graft device into apposition with the aorta.

14. The method of claim 13, wherein the treatment site includes a dissection in an ascending segment of the aorta.

15. The method of claim 13, wherein the treatment site includes a dissection in a descending segment of the aorta.

16. The method of claim 13, wherein the treatment site includes a dissection in an arch of the aorta.

17. The method of claim 1, wherein device comprises a stent-graft.

18. A method for positioning a device in a blood vessel of a patient adjacent to the heart, the method comprising:

advancing a venous catheter endoluminally from a venous site to the heart;

advancing a snare from the venous catheter through a valve in the heart to a blood vessel adjacent to the heart;

advancing a shaped wire endoluminally from an arterial site toward the heart;

drawing the shaped wire into the venous catheter using the snare to provide a rail from the arterial site to the venous site;

advancing an arterial catheter over the shaped wire such that tip portions of the venous and arterial catheters are brought into adjacency; and

deploying a device within the blood vessel from a platform extending from the venous catheter to the arterial site, the blood vessel being adjacent to the heart.

19. The method of claim 18, wherein deploying a device comprises:

advancing a graft device disposed on, over or within the platform to a position within an ascending aorta of the patient;

positioning the graft device at a treatment site within the aorta; and

expanding the graft device into apposition with the aorta.

20. The method of claim 19, wherein the treatment site includes a dissection in an ascending segment of the aorta.

21. The method of claim 19, wherein the treatment site includes a dissection in a descending segment of the aorta.

22. The method of claim 19, wherein the treatment site includes a dissection in an arch of the aorta.

23. The method of claim 18, wherein device comprises a stent-graft.