Apparatus and methods for deployment of linked prosthetic segments

• US 8,652,198 B2
• Filed: 03/19/2007
• Issued: 02/18/2014
• Est. Priority Date: 03/20/2006
• Status: Active Grant

• Current Assignee: JW Medical Systems Ltd
• Original Assignee: JW Medical Systems Ltd
• Inventors: Andreas, Bernard, Chew, Sunmi, Dittmer, Jeremy, Grainger, Jeff, Kao, Stephen, Lowe, David, Mao, Bryan, Olson, Steve, Snow, David, Welk, Craig
• Primary Examiner(s): Nguyen, Victor
• Assistant Examiner(s): EVERAGE, KEVIN D
• Application Number:
  US11/687,885
• Publication Number:
  US 20070219612A1
• Time in Patent Office: 2,528 Days
• Field of Search: 623/1.11, 623/1.16, 623/1.12, 623/1.23
• US Class Current: 623/1.16
• CPC Class Codes: A61B 17/12022 Occluding by internal devices, e.g. balloons or releasable wires plugging an opening in the wall of an organ A61B17/0057; occluders for the cervical canal A61F6/146; vas deferens occluders A61F6/20
• CPC Class Codes: A61B 2017/1205 Introduction devices
• CPC Class Codes: A61B 2017/12068 detachable by heat
• CPC Class Codes: A61F 2/852 Two or more distinct overlapping stents
• CPC Class Codes: A61F 2/89 the wire-like elements comprising two or more adjacent rings flexibly connected by separate members
• CPC Class Codes: A61F 2/91 made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes
• CPC Class Codes: A61F 2/915 with bands having a meander structure, adjacent bands being connected to each other
• CPC Class Codes: A61F 2/95 Instruments specially adapted for placement or removal of stents or stent-grafts
• CPC Class Codes: A61F 2/958 Inflatable balloons for placing stents or stent-grafts
• CPC Class Codes: A61F 2002/30329 Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
• CPC Class Codes: A61F 2002/30545 for adjusting a diameter
• CPC Class Codes: A61F 2002/30599 stackable
• CPC Class Codes: A61F 2002/826 more than one stent being applied sequentially
• CPC Class Codes: A61F 2002/828 Means for connecting a plurality of stents allowing flexibility of the whole structure
• CPC Class Codes: A61F 2002/91508 the meander having a difference in amplitude along the band
• CPC Class Codes: A61F 2002/91525 within the whole structure different bands showing different meander characteristics, e.g. frequency or amplitude
• CPC Class Codes: A61F 2002/91533 characterised by the phase between adjacent bands
• CPC Class Codes: A61F 2002/91541 Adjacent bands are arranged out of phase
• CPC Class Codes: A61F 2002/91558 connected peak to peak
• CPC Class Codes: A61F 2002/91575 connected peak to trough
• CPC Class Codes: A61F 2002/91591 : Locking connectors, e.g. using male-female connections
• CPC Class Codes: A61F 2002/9665 : with additional retaining means
• CPC Class Codes: A61F 2220/0008 : Fixation appliances for connecting prostheses to the body
• CPC Class Codes: A61F 2220/0025 : Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
• CPC Class Codes: A61F 2220/005 : using adhesives
• CPC Class Codes: A61F 2220/0058 : soldered or brazed or welded
• CPC Class Codes: A61F 2230/0013 : Horseshoe-shaped, e.g. crescent-shaped, C-shaped, U-shaped
• CPC Class Codes: A61F 2230/0067 : conical
• CPC Class Codes: A61F 2250/001 : for adjusting a diameter
• CPC Class Codes: A61F 2250/0063 : Nested prosthetic parts
• CPC Class Codes: A61F 2250/0071 : breakable or frangible

Abstract

A luminal prosthesis comprises a plurality of radially expandable prosthetic stent segments arranged axially. Two or more of the prosthetic stent segments are separable upon expansion from the remaining prosthetic stent segments and a coupling structure connects at least some of the adjacent prosthetic stent segments to each other. The coupling structure permits a first group of the adjacent prosthetic stent segments to separate from a second group of the prosthetic stent segments upon differential radial expansion of the first group relative to the second group and the coupling structure maintains or forms an attachment between the adjacent prosthetic stent segments in the first group which have been expanded together. A delivery system and methods for deploying the multiple coupled prosthetic stent segments are also disclosed.

Claims

1. A method for delivering a luminal prosthesis to at least one treatment site, the method comprising:

providing a plurality of radially expandable prosthetic stent segments arranged axially along a delivery catheter and within a sheath of the delivery catheter, wherein at least some adjacent prosthetic stent segments have a coupling structure therebetween;

positioning the delivery catheter at a first treatment site;

selecting two or more prosthetic stent segments for deployment; and

decoupling the two or more prosthetic stent segments from the remaining stent segments by expanding a decoupling balloon within the sheath of the delivery catheter so as to engage the coupling structure, wherein the decoupling balloon is positioned near the distal end of the delivery catheter, and wherein a proximal end of the two or more prosthetic stent segments is decoupled from a distal end of the remaining stent segments upon engagement of the coupling structure while being disposed within the sheath of the delivery catheter;

radially expanding the selected two or more prosthetic stent segments without expanding the remaining prosthetic stent segments, wherein the two or more prosthetic stent segments are expanded by an expansion element, wherein the expansion element is separate from the decoupling balloon, and wherein the coupling structure permits the selected prosthetic stent segments to separate from the remaining prosthetic stent segments while maintaining or forming an attachment between the selected prosthetic stent segments when expanded.

2. The method of claim 1, wherein the coupling structure comprises adjacent prosthetic stent segments with overlapping prosthetic stent segment ends.

3. The method of claim 1, wherein the coupling structure is broken by inflation of the decoupling balloon, permitting a first group of the prosthetic stent segments to separate from a second group of the prosthetic stent segments.

4. A luminal prosthesis comprising:

a plurality of radially expandable prosthetic stent segments arranged axially, wherein a group of two or more adjacent prosthetic stent segments is separable upon expansion from the remaining prosthetic stent segments;

a sheath axially positionable to cover the plurality of radially expandable prosthetic stent segments, wherein the sheath is retractable to expose the group of two or more adjacent prosthetic stent segments while covering the remaining prosthetic stent segments;

a coupling structure between at least some of the adjacent prosthetic stent segments for limiting relative axial movement therebetween, wherein the coupling structure permits a first group of the adjacent prosthetic stent segments to separate from a second group of the prosthetic stent segments upon differential radial expansion within the sheath of a proximal end of the first group of stent segments relative to a distal end of the second group of stent segments, wherein the coupling structure maintains or forms an attachment between the adjacent prosthetic stent segments in the first group which have been expanded together; and

an expansion element for radially expanding the first group of stent segments wherein engaging the first group of stent segments with the expansion element uncouples the coupling structure between the first group of stent segments and the second group of stent segments by differential radial expansion such that the proximal end of the first group of stent segments is decoupled from the distal end of the second group of stent segments while being positioned within the sheath;

wherein an inner lumen of the sheath is radially expanded at a distal end, the radially expanded inner lumen limiting the radial expansion of the expansion element, and wherein the first group of stent segments is decoupled from the second group of stent segments while positioned within the radially expanded inner lumen.

5. The luminal prosthesis of claim 4, wherein the coupling structure permanently couples the first group of stent segments after radial expansion of the first group of stent segments.

6. The luminal prosthesis of claim 4, wherein the coupling structure couples the adjacent prosthetic stent segments long enough to permit endothelialization of the expanded prosthetic stent segments.

7. The luminal prosthesis of claim 4, wherein the coupling structure comprises adjacent prosthetic stent segments with overlapping prosthetic stent segment ends.

8. The luminal prosthesis of claim 4, wherein the expansion element comprises a balloon.

9. A luminal prosthesis comprising:

a plurality of radially expandable prosthetic stent segments arranged axially wherein a group of two or more adjacent prosthetic stent segments is separable upon expansion from the remaining prosthetic stent segments;

a sheath axially positionable to cover the plurality of radially expandable prosthetic stent segments, wherein the sheath is retractable to expose the group of two or more adjacent prosthetic stent segments while covering the remaining prosthetic stent segments;

a breakable coupling structure between at least some of the adjacent prosthetic stent segments for limiting relative axial movement therebetween, the coupling structure permitting a first group of the adjacent prosthetic stent segments to separate from a second group of the prosthetic stent segments upon differential radial expansion within the sheath of a proximal end of the first group relative to a distal end of the second group, wherein the coupling structure maintains an attachment between adjacent prosthetic stent segments in the first group which have been expanded together; and

an expansion element for radially expanding the first group of stent segments;

a decoupling element, wherein engaging the first group of stent segments with the decoupling element uncouples the coupling structure between the first group of stent segments and the second group of stent segments by differential radial expansion such that the proximal end of the first group of stent segments is decoupled from the distal end of the second group of stent segments while being positioned within the sheath.

10. The luminal prosthesis of claim 9, wherein the coupling structure comprises a breakable link extending between adjacent prosthetic stent segments.

11. The luminal prosthesis of claim 9, wherein the coupling structure comprises a polymer layer between or across adjacent prosthetic stent segments.

12. The luminal prosthesis of claim 9, wherein the coupling structure is bioerodable.

13. The luminal prosthesis of claim 9, wherein the expansion element and the decoupling element comprise the same element.

14. A luminal prosthesis delivery system comprising

a delivery catheter having a proximal end and a distal end;

a plurality of radially expandable prosthetic stent segments arranged axially near the distal end of the delivery catheter, wherein a group of two or more adjacent prosthetic stent segments is separable upon expansion from the remaining prosthetic stent segments;

a sheath axially positionable to cover the plurality of radially expandable prosthetic stent segments;

a coupling structure between at least some of the adjacent prosthetic stent segments, wherein the coupling structure permits a first group of the adjacent prosthetic stent segments to separate from a second group of the prosthetic stent segments upon differential radial expansion within the sheath of a proximal end of the first group relative to a distal end of the second group, wherein the coupling structure maintains an attachment between adjacent prosthetic stent segments in the first group which have been expanded together; and

an expansion element for radially expanding the first group, wherein engaging the first group with the expansion element uncouples the coupling structure between the first group and the second group by differential radial expansion such that the proximal end of the first group is decoupled from the distal end of the second group while being positioned within the sheath.

15. The luminal prosthesis delivery system of claim 14, wherein the expansion element comprises a balloon disposed on the distal end of the delivery catheter.

16. The luminal prosthesis delivery system of claim 15, wherein the coupling structure is broken by inflation of the balloon.

17. The luminal prosthesis delivery system of claim 14, wherein the sheath comprises a garage located at the distal end of the delivery catheter, wherein the garage limits the radial expansion of the expansion element, and wherein the proximal end of the first group is decoupled from a distal end of the second group while positioned within the garage.

18. The luminal prosthesis delivery system of claim 14, wherein the sheath is retractable to expose the first group of prosthetic stent segments while covering the second group of prosthetic stent segments.