Stent Delivery Under Direct Visualization

• US 20150025614A1
• Filed: 09/18/2014
• Published: 01/22/2015
• Est. Priority Date: 02/07/2008
• Status: Active Grant

• Current Assignee: Intuitive Surgical Operations, Inc. (Intuitive Surgical Holdings, LLC)
• Original Assignee: Intuitive Surgical Operations, Inc. (Intuitive Surgical Holdings, LLC)
• Inventors: Miller, David, Saadat, Vahid, Peh, Ruey-Feng
• Granted Patent: US 10,278,849 B2
• Time in Patent Office: Days
• US Class Current: 623/1.11
• CPC Class Codes: A61B 1/00089 Hoods
• CPC Class Codes: A61B 1/044 for absorption imaging
• CPC Class Codes: A61B 1/12 with cooling or rinsing arrangements
• CPC Class Codes: A61B 34/20 Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
• CPC Class Codes: A61F 2/958 Inflatable balloons for placing stents or stent-grafts
• CPC Class Codes: A61F 2002/821 Ostial stents
• CPC Class Codes: A61F 2250/0039 differing in diameter

Abstract

Stent delivery under direct visualization utilizing an imaging hood is described herein. A stent may be delivered and placed in or around lesions, e.g., ostial lesions, through a delivery catheter while being directly visualized via an imaging hood. A pre-delivery assessment probe may also be advanced to the desired site for accurate placement of the stent.

Claims

1-18. -18. (canceled)

19. A tissue manipulation system, comprising:

a reconfigurable hood structure with a distal end, the structure having a low profile delivery configuration and an expanded deployed configuration which defines an open area bounded at least in part by the structure and by a membrane extending across the hood structure distal end, the open area in fluid communication with an environment external to the hood structure;

a fluid lumen in communication with the open area such that introduction of a fluid through the lumen purges the open area of blood;

an inflatable balloon member translatable through an aperture in the membrane and distal to the open area; and

an expandable stent positioned upon the balloon member.

20. The system of claim 19 further comprising an imaging element positioned within or along the structure such that the open area is visualized through the fluid by the element.

21. The system of claim 19 wherein the inflatable balloon is translatable through the hood when the balloon is uninflated.

22. The system of claim 19 further comprising a guidewire positioned through the hood.

23. The system of claim 19 wherein the reconfigurable structure comprises a visualization balloon positioned proximal to the inflatable balloon member.

24. The system of claim 19 further comprising a measurement catheter defining one or more indications thereon and which is advanceable through the hood distal to the open area.

25. The system of claim 19 further comprising one or more expandable measurement members positioned along a support member which is advanceable through the hood structure distal to the open area.

26. The system of claim 25 wherein each of the one or more expandable measurement members has a predetermined diameter whereby each subsequent expandable measurement member increases in diameter from a preceding member.

27. The system of claim 25 wherein the one or more expandable measurement members are maintained with a sheath during advancement through the hood structure.

29. A tissue manipulation system, comprising:

a reconfigurable hood structure with a distal end, the structure having a low profile delivery configuration and an expanded deployed configuration which defines an open area bounded at least in part by the structure and by a membrane extending across the hood structure distal end, the open area in fluid communication with an environment external to the hood structure, wherein the hood structure asymmetric;

a catheter in communication with the open area such that introduction of a fluid through the catheter purges the open area of bodily fluid; and

an imaging element positioned on the hood structure such that the open area is visualized through the fluid by the element.

30. The system of claim 29 wherein the membrane adjacent to the aperture is non-perpendicular to the catheter.

31. The system of claim 29 wherein the catheter includes a steerable segment proximal to the hood structure.

32. The system of claim 31 wherein the steerable segment includes pivotally connected links.

33. The system of claim 29 wherein the catheter includes a passively pre-shaped bend proximal to the hood structure.