Devices and methods for controlling and indicating the length of an interventional element

• US 7,326,236 B2
• Filed: 12/23/2003
• Issued: 02/05/2008
• Est. Priority Date: 12/23/2003
• Status: Active Grant

• Current Assignee: JW Medical Systems Ltd
• Original Assignee: XTENT, Inc.
• Inventors: Andreas, Bernard, Flom, James R., Blackwood, Bradley, Karratt, Joseph
• Primary Examiner(s): Manahan; Todd E.
• Assistant Examiner(s): Neal; Timothy J
• Application Number:
  US10/746,466
• Publication Number:
  US 20050149159A1
• Time in Patent Office: 1,505 Days
• Field of Search: 623/1.11, 606/108, 606191-194
• US Class Current: 623/1.11
• CPC Class Codes: A61F 2/95 Instruments specially adapted for placement or removal of stents or stent-grafts
• CPC Class Codes: A61F 2/9517 handle assemblies therefor
• 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 2250/0097 Visible markings, e.g. indicia
• CPC Class Codes: A61M 2025/0008 having visible markings on its surface, i.e. visible to the naked eye, for any purpose, e.g. insertion depth markers, rotational markers or identification of type
• CPC Class Codes: A61M 2025/1068 having means for varying the length or diameter of the deployed balloon, this variations could be caused by excess pressure
• CPC Class Codes: A61M 25/0136 Handles therefor

Abstract

Devices and methods are provided for controlling and indicating the deployed length of an interventional element on an interventional catheter. The interventional element may be a stent or series of stents, a balloon, or any other interventional element for which length control is necessary or desirable. Devices for controlling the length of the interventional element include gear driven actuators, motors, and other mechanisms. Devices for indicating length of an interventional element to the user include sensors, detents, visual displays and other mechanisms providing visual, audible, and tangible indications of length to the user. The control and indication devices preferably work in tandem to enable highly precise adjustment of interventional element length.

Claims

1. A method of deploying a stent at a target site in a patient'"'"'s body, the method comprising:

positioning a distal end of a delivery catheter near the target site, the stent being releasably coupled to the distal end, a proximal portion of the delivery catheter being disposed outside the patient'"'"'s body, the stent having a total length;

adjusting a first length of a deployable portion of the stent with the delivery catheter positioned in the patient'"'"'s body, the first length being less than the total length;

receiving an indication of the first length from an indication on the proximal portion of the delivery catheter; and

after receiving the indication of first length, deploying only the deployable portion of the stent at the target site while a second portion of the stent remains undeployed on the delivery catheter, unconnected to the deployable portion.

2. The method of claim 1 wherein adjusting the length of the deployable portion comprises moving an actuator associated with the proximal portion of the delivery catheter through a distance correlated with the length.

3. The method of claim 2 wherein the actuator is movable through a stroke, each stroke of the actuator adjusting the length a predetermined amount.

4. The method of claim 3 wherein the stent comprises a plurality of stent segments, and the stroke corresponds to a segment length of one of the stent segments.

5. The method of claim 2 wherein the indication device comprises a stop that limits the movement of the actuator.

6. The catheter of claim 1 wherein the indication of the length is received from an output device associated with the proximal end of the catheter.

7. The method of claim 6 wherein the output device is coupled to a sensor, the method further comprising detecting the length with the sensor.

8. The method of claim 7 wherein the sensor is disposed near the distal end of the delivery catheter.

9. The method of claim 7 wherein the sensor optically detects the working length.

10. The method of claim 7 wherein the sensor magnetically detects the working length.

11. The method of claim 1 wherein receiving the indication of the length comprises observing a visual indication.

12. The method of claim 11 wherein the visual indication comprises indicia displayed on the proximal portion of the delivery catheter.

13. The method of claim 1 wherein receiving the indication of length comprises hearing an audible indication.

14. The method of claim 1 wherein receiving the indication of length comprises feeling a tactile indication.

15. The method of claim 14 wherein the tactile indication is received from a detent engaging a detent receiving structure associated with the delivery catheter.

16. The method of claim 1 wherein adjusting the length comprises moving a ratchet mechanism to adjust the length the a first direction, the ratchet preventing adjustment of the length in a second direction.

17. The method of claim 1 wherein the stent comprises a plurality of separable stent segments and adjusting the length comprises constraining at least a first stent segment from expansion while leaving at least a second stent segment unconstrained from expansion.

18. The method of claim 17 wherein adjusting the length comprises moving a sheath relative to the stern segments for selectively covering the first stent segment and exposing the second stent segment.

19. The method of claim 17 wherein the indication is correlated with the number of stent segments.

20. The method of claim 18 wherein the indication is correlated with movement of the sheath relative to the stent.

21. The method of claim 17 further comprising axially separating the first stent segment from the second stern segment prior to expansion thereof.

23. The method of claim 1 further comprising receiving an indication of the second length from a second indicator on the proximal portion of the catheter.

22. A method of deploying a stent at a target site in a patient'"'"'s body, the method comprising:

positioning a distal end of a delivery catheter near the target site, the stent being releasably coupled to the distal end, a proximal portion of the delivery catheter being disposed outside the patient'"'"'s body;

adjusting the length of a deployable portion of the stent with the delivery catheter positioned in the patient'"'"'s body;

receiving an indication of the length from the proximal portion of the delivery catheter;

after receiving the, indication, deploying the deployable portion of the stent at the target site,

wherein the stent comprises a plurality of separable stent segments and adjusting the length comprises constraining at least a first stent segment from expansion while leaving at least a second stent segment unconstrained from expansion;

axially separating the first stent segment from the second stent segment prior to expansion thereof; and

moving the actuator to a first position for controlling the number of stent segments in the deployable portion and moving the actuator to a second position for controlling the separation between the first and send stent segments.