CA2333764A1 - Deformable scaffolding multicellular stent - Google Patents
Deformable scaffolding multicellular stent Download PDFInfo
- Publication number
- CA2333764A1 CA2333764A1 CA002333764A CA2333764A CA2333764A1 CA 2333764 A1 CA2333764 A1 CA 2333764A1 CA 002333764 A CA002333764 A CA 002333764A CA 2333764 A CA2333764 A CA 2333764A CA 2333764 A1 CA2333764 A1 CA 2333764A1
- Authority
- CA
- Canada
- Prior art keywords
- stent
- expandable
- outer sheath
- segments
- channel
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Abandoned
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
- A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
- A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
- A61B17/12027—Type of occlusion
- A61B17/1204—Type of occlusion temporary occlusion
- A61B17/12045—Type of occlusion temporary occlusion double occlusion, e.g. during anastomosis
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
- A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
- A61B17/12099—Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder
- A61B17/12109—Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder in a blood vessel
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
- A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
- A61B17/12131—Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device
- A61B17/12136—Balloons
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B17/3417—Details of tips or shafts, e.g. grooves, expandable, bendable; Multiple coaxial sliding cannulas, e.g. for dilating
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/04—Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
- A61F2/06—Blood vessels
- A61F2/064—Blood vessels with special features to facilitate anastomotic coupling
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/24—Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body
- A61F2/2493—Transmyocardial revascularisation [TMR] devices
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/86—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure
- A61F2/90—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure
- A61F2/91—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/86—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure
- A61F2/90—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure
- A61F2/91—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes
- A61F2/915—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes with bands having a meander structure, adjacent bands being connected to each other
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/95—Instruments specially adapted for placement or removal of stents or stent-grafts
- A61F2/958—Inflatable balloons for placing stents or stent-grafts
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00491—Surgical glue applicators
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/064—Surgical staples, i.e. penetrating the tissue
- A61B17/0643—Surgical staples, i.e. penetrating the tissue with separate closing member, e.g. for interlocking with staple
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
- A61B18/1477—Needle-like probes
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
- A61B18/1492—Probes or electrodes therefor having a flexible, catheter-like structure, e.g. for heart ablation
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
- A61B2017/00238—Type of minimally invasive operation
- A61B2017/00243—Type of minimally invasive operation cardiac
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
- A61B2017/00238—Type of minimally invasive operation
- A61B2017/00243—Type of minimally invasive operation cardiac
- A61B2017/00247—Making holes in the wall of the heart, e.g. laser Myocardial revascularization
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
- A61B2017/00238—Type of minimally invasive operation
- A61B2017/00243—Type of minimally invasive operation cardiac
- A61B2017/00247—Making holes in the wall of the heart, e.g. laser Myocardial revascularization
- A61B2017/00252—Making holes in the wall of the heart, e.g. laser Myocardial revascularization for by-pass connections, i.e. connections from heart chamber to blood vessel or from blood vessel to blood vessel
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/00491—Surgical glue applicators
- A61B2017/00504—Tissue welding
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
- A61B2017/1107—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis for blood vessels
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/11—Surgical instruments, devices or methods, e.g. tourniquets for performing anastomosis; Buttons for anastomosis
- A61B2017/1139—Side-to-side connections, e.g. shunt or X-connections
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
- A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
- A61B2017/1205—Introduction devices
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
- A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
- A61B2017/12127—Double occlusion, e.g. for creating blood-free anastomosis site
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/30—Surgical pincettes without pivotal connections
- A61B2017/306—Surgical pincettes without pivotal connections holding by means of suction
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/34—Trocars; Puncturing needles
- A61B2017/347—Locking means, e.g. for locking instrument in cannula
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B2018/00315—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
- A61B2018/00345—Vascular system
- A61B2018/00351—Heart
- A61B2018/00392—Transmyocardial revascularisation
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
- A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
- A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
- A61B18/14—Probes or electrodes therefor
- A61B2018/1405—Electrodes having a specific shape
- A61B2018/1425—Needle
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
- A61B90/40—Apparatus fixed or close to patients specially adapted for providing an aseptic surgical environment
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/04—Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
- A61F2/06—Blood vessels
- A61F2/07—Stent-grafts
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/86—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure
- A61F2/90—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/04—Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
- A61F2/06—Blood vessels
- A61F2002/061—Blood vessels provided with means for allowing access to secondary lumens
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30003—Material related properties of the prosthesis or of a coating on the prosthesis
- A61F2002/3006—Properties of materials and coating materials
- A61F2002/30079—Properties of materials and coating materials magnetic
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2002/825—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents having longitudinal struts
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/86—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure
- A61F2/90—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure
- A61F2/91—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes
- A61F2/915—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes with bands having a meander structure, adjacent bands being connected to each other
- A61F2002/91508—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes with bands having a meander structure, adjacent bands being connected to each other the meander having a difference in amplitude along the band
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/86—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure
- A61F2/90—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure
- A61F2/91—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes
- A61F2/915—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes with bands having a meander structure, adjacent bands being connected to each other
- A61F2002/91525—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes with bands having a meander structure, adjacent bands being connected to each other within the whole structure different bands showing different meander characteristics, e.g. frequency or amplitude
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/86—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure
- A61F2/90—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure
- A61F2/91—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes
- A61F2/915—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes with bands having a meander structure, adjacent bands being connected to each other
- A61F2002/91533—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes with bands having a meander structure, adjacent bands being connected to each other characterised by the phase between adjacent bands
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/86—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure
- A61F2/90—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure
- A61F2/91—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes
- A61F2/915—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes with bands having a meander structure, adjacent bands being connected to each other
- A61F2002/9155—Adjacent bands being connected to each other
- A61F2002/91558—Adjacent bands being connected to each other connected peak to peak
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/86—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure
- A61F2/90—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure
- A61F2/91—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes
- A61F2/915—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes with bands having a meander structure, adjacent bands being connected to each other
- A61F2002/9155—Adjacent bands being connected to each other
- A61F2002/91575—Adjacent bands being connected to each other connected peak to trough
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/86—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure
- A61F2/90—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure
- A61F2/91—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes
- A61F2/915—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes with bands having a meander structure, adjacent bands being connected to each other
- A61F2002/9155—Adjacent bands being connected to each other
- A61F2002/91591—Locking connectors, e.g. using male-female connections
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2210/00—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2210/009—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof magnetic
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2250/0014—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis
- A61F2250/0048—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis differing in mechanical expandability, e.g. in mechanical, self- or balloon expandability
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/0067—Catheters; Hollow probes characterised by the distal end, e.g. tips
- A61M25/0074—Dynamic characteristics of the catheter tip, e.g. openable, closable, expandable or deformable
- A61M25/0075—Valve means
- A61M2025/0076—Unidirectional valves
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/0067—Catheters; Hollow probes characterised by the distal end, e.g. tips
- A61M25/0082—Catheter tip comprising a tool
- A61M25/0084—Catheter tip comprising a tool being one or more injection needles
- A61M2025/0089—Single injection needle protruding axially, i.e. along the longitudinal axis of the catheter, from the distal tip
- A61M2025/009—Single injection needle protruding axially, i.e. along the longitudinal axis of the catheter, from the distal tip the needle having a bent tip, i.e. the needle distal tip is angled in relation to the longitudinal axis of the catheter
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/10—Balloon catheters
- A61M2025/1043—Balloon catheters with special features or adapted for special applications
- A61M2025/1052—Balloon catheters with special features or adapted for special applications for temporarily occluding a vessel for isolating a sector
Abstract
A plastically deformable stent (10) for implantation within a body passage includes a plurality of cylindrical segments (12), and a plurality of connectors (14) extending between adjacent segments (12). Each segment (12) has an alternating pattern of curvilinear elements (20) extending about its circumference, including first (22), and second (24) sets of curvilinear elements having different resistances to expansion, preferably defining "U" shapes with alternating lengths that are connected to one another to define a substantially sinusoidal pattern. The connectors (14) define sinusoidal shap e adapted to extend, and compress axially substantially evenly when the adjace nt segments are subjected to bending. The stent (10) may be delivered on a devi ce including an elongate member with a nose cone (2, 12), an expandable member (208), and a proximal shoulder thereon (216), and an outer sheath (220) for slide receiving the elongate member therein. The outer sheath (220), and/or nose cone (212) may have perfusion holes for allowing continued perfusion of fluid during stent delivery. The devicve may be used in a method for implanting a stent within a curved region of a body passage, particularly fo r creating, and/or maintaining a channel connecting vein to an adjacent artery , preferably in the coronary system.
Description
DESCRIPTION
DEFORMABLE SCAFFOLDING MULTICELLULAR STENT
This application is a continuation-in-part of application Serial No. 08/970,694 filed November 14, 1997, the disclosure of which is expressly incorporated herein by reference.
FIELD OF THE INVENTION
The present invention relates generally to implantable devices for use within the cardiovascular system, and more particularly to deformable prostheses for implantation within and/or between blood vessels, and to methods of using them.
BACKGROUND
A variety of stents are known for use within arteries of a patient for treating stenoses, strictures, aneurysms, and the like. For example, a stmt may be implanted within a partially occluded region of an artery to retain stenotic material beneath the stmt and/or to open the lumen of the artery to improve blood flow therethrough.
Stents generally have a substantially cylindrical shape and are expandable between a contracted condition for facilitating delivery and an enlarged condition for engaging the vessel wall after deployment within the artery. Stents may be self-expanding, i.e., they may be biased to the enlarged condition but restrained in the contracted condition during delivery, for example within a sheath.
Alternatively, stems may be substantially malleable or plastically deformable, i.e., the stent may be delivered in a contracted condition on a delivery catheter, and expanded WO 99/62430 PCTlUS99/10645
DEFORMABLE SCAFFOLDING MULTICELLULAR STENT
This application is a continuation-in-part of application Serial No. 08/970,694 filed November 14, 1997, the disclosure of which is expressly incorporated herein by reference.
FIELD OF THE INVENTION
The present invention relates generally to implantable devices for use within the cardiovascular system, and more particularly to deformable prostheses for implantation within and/or between blood vessels, and to methods of using them.
BACKGROUND
A variety of stents are known for use within arteries of a patient for treating stenoses, strictures, aneurysms, and the like. For example, a stmt may be implanted within a partially occluded region of an artery to retain stenotic material beneath the stmt and/or to open the lumen of the artery to improve blood flow therethrough.
Stents generally have a substantially cylindrical shape and are expandable between a contracted condition for facilitating delivery and an enlarged condition for engaging the vessel wall after deployment within the artery. Stents may be self-expanding, i.e., they may be biased to the enlarged condition but restrained in the contracted condition during delivery, for example within a sheath.
Alternatively, stems may be substantially malleable or plastically deformable, i.e., the stent may be delivered in a contracted condition on a delivery catheter, and expanded WO 99/62430 PCTlUS99/10645
2 by a balloon on the delivery catheter, until it plastically deforms into the enlarged condition.
Many stems include a plurality of segments or cells that are separated by one or more connectors extending between adjacent segments. For example, U.S. Patent No.
5,104,404 discloses an expandable stent that includes a number of cylindrical segments, with single hinges connecting adjacent segments. Because of the rigidity of the individual segments of the stent, the hinges are intended to provide articulation between the adjacent segments.
When the stem is deployed within a curved portion of a vessel, the individual segments substantially resist bending to conform to the curvature of the vessel, The articulation provided by the hinges allows some conformity with the curvature of the vessel; however, the hinges may create gaps between the segments and/or may cause the segments to overlap one another. Material, such as stenotic material on the vessel wall, may extend through the gaps into the vessel lumen, possibly obstructing blood flow and/or breaking loose and traveling downstream where they may cause substantial damage to the patient being treated.
To reduce the likelihood of gaps occurring, some stems provide a number of connectors extending between adjacent segments. Increasing the number of connectors substantially, however, may increase the rigidity of the stmt, which may cause problems during scent delivery, For example, when the stmt is being delivered along a circuitous arterial path, the rigidity of the stent, particularly in its contracted condition, may impair advancement of the stmt around tight bends in the artery.
Alternatively, some stems may include flexible connectors that are deformed when the segments are expanded to the enlarged condition. The resulting connectors may deform substantially to become part of the stmt structure,
Many stems include a plurality of segments or cells that are separated by one or more connectors extending between adjacent segments. For example, U.S. Patent No.
5,104,404 discloses an expandable stent that includes a number of cylindrical segments, with single hinges connecting adjacent segments. Because of the rigidity of the individual segments of the stent, the hinges are intended to provide articulation between the adjacent segments.
When the stem is deployed within a curved portion of a vessel, the individual segments substantially resist bending to conform to the curvature of the vessel, The articulation provided by the hinges allows some conformity with the curvature of the vessel; however, the hinges may create gaps between the segments and/or may cause the segments to overlap one another. Material, such as stenotic material on the vessel wall, may extend through the gaps into the vessel lumen, possibly obstructing blood flow and/or breaking loose and traveling downstream where they may cause substantial damage to the patient being treated.
To reduce the likelihood of gaps occurring, some stems provide a number of connectors extending between adjacent segments. Increasing the number of connectors substantially, however, may increase the rigidity of the stmt, which may cause problems during scent delivery, For example, when the stmt is being delivered along a circuitous arterial path, the rigidity of the stent, particularly in its contracted condition, may impair advancement of the stmt around tight bends in the artery.
Alternatively, some stems may include flexible connectors that are deformed when the segments are expanded to the enlarged condition. The resulting connectors may deform substantially to become part of the stmt structure,
3 i.e., they may deform substantially such that they lose their flexibility and are then unable to accommodate transverse bending forces.
I.n addition, some known stems have substantial gaps within the individual segments themselves or between the connectors, and so may not effectively "scaffold" the underlying vessel wall, i.e., may not support the vessel wall to maintain a desired open lumen cross-section and/or may expose material extending from the vessel wall into the bloodstream. Initially, stents in their contracted condition may have substantially few gaps within the individual segments, i.e., peripherally about the circumference of the segments. When the stems are expanded to their enlarged condition, however, substantial gaps may be created at one or points along the circumference either within the segments, due to the design of the segments or to uneven expansion of the individual segments, or between the connectors.
The risk of uneven radial expansion may be particularly problematic with respect to balloon-expandable stems due to the nature of the balloons generally used. Balloon-expandable stents are typically manually compressed onto an inelastic balloon provided on the delivery catheter.
Because of its inelasticity, the balloon is typically rolled circumferentially or otherwise wrapped around the catheter before the stmt is placed over it, thereby attempting to ensure that the balloon is not snagged or damaged during delivery or deployment of the stent.
Once the stent is delivered intraluminally to a desired region within a vessel, the balloon is inflated to expand the stent to its enlarged condition. As the balloon unwraps during inflation, it may subject the stent to radial forces that are not substantially even along the length and/or the circumference of the stmt. More particularly, some regions of the balloon may expand more quickly than other regions
I.n addition, some known stems have substantial gaps within the individual segments themselves or between the connectors, and so may not effectively "scaffold" the underlying vessel wall, i.e., may not support the vessel wall to maintain a desired open lumen cross-section and/or may expose material extending from the vessel wall into the bloodstream. Initially, stents in their contracted condition may have substantially few gaps within the individual segments, i.e., peripherally about the circumference of the segments. When the stems are expanded to their enlarged condition, however, substantial gaps may be created at one or points along the circumference either within the segments, due to the design of the segments or to uneven expansion of the individual segments, or between the connectors.
The risk of uneven radial expansion may be particularly problematic with respect to balloon-expandable stems due to the nature of the balloons generally used. Balloon-expandable stents are typically manually compressed onto an inelastic balloon provided on the delivery catheter.
Because of its inelasticity, the balloon is typically rolled circumferentially or otherwise wrapped around the catheter before the stmt is placed over it, thereby attempting to ensure that the balloon is not snagged or damaged during delivery or deployment of the stent.
Once the stent is delivered intraluminally to a desired region within a vessel, the balloon is inflated to expand the stent to its enlarged condition. As the balloon unwraps during inflation, it may subject the stent to radial forces that are not substantially even along the length and/or the circumference of the stmt. More particularly, some regions of the balloon may expand more quickly than other regions
4 that have not yet fully unwrapped, causing localized heightened radial forces which may cause uneven radial expansion of the stem . Because of the unevenly distributed forces, a portion of the circumference of the stent overlying an initially unwrapped region of the balloon may be expanded greater than an adjacent portion where the balloon has not yet fully unwrapped. This may substantially increase the risk of over-expanding portions of the stmt, and thereby creating gaps in the over-expanded portions.
In an effort to provide a uniform enlarged condition, stems generally have a substantially uniform pattern extending about the circumference of the individual segments, and generally have segments of equal lengths.
Because of the uneven radial forces which may be encountered during expansion, however, these stents may not expand substantially uniformly despite the intended result of their uniform designs. This problem may be further exacerbated because individual stems are generally intended to be expanded to a range of potential enlarged sizes, for example, between 3.0 mm and 5.5 mm. While at the upper end of the range, the radial forces may become more even and expand the stmt more uniformly, the stmt may be prone to uneven expansion at the lower end of the range, where localized heightened radial forces are more likely to occur.
Accordingly, it is believed that there is a need for stems which more effectively scaffold the vessel wall and/or which substantially evenly engage vessel walls, particularly within curved vessel regions, and for methods and systems using such stents.
SUMMARY OF THE INVENTION
The present invention is directed to implantable devices for use within body passages, particularly within the cardiovascular system, and more particularly to deformable prostheses for implantation within and/or between S
blood vessels, and to methods of using them to create and/or maintain connections between adjacent blood vessels.
In one aspect of the present invention, a stent is provided for implantation within a body passage that includes a plurality of expandable segments defining a circumference and a longitudinal axis, and a connector extending between adjacent segments. Each segment includes an alt:ernating pattern of curvilinear elements extending about the circumference.
l~n a preferred embodiment, the alternating pattern includes a first set of curvilinear elements having a first resistance to expansion and a second set of curvilinear elements having a second resistance to expansion substantially higher than the first resistance to expansion.
Consequently, each segment is expandable between a contracted condition, a first or intermediate expanded condition, and a second or final expanded condition.
Preferably, the first expanded condition is achieved when a radial force exceeding the first resistance to expansion is applied to the segment, and the second expanded condition is achieved when a radial force exceeding the second resistance to expansion is applied to the segment.
More preferably, the first and second sets of curviJ_inear elements are substantially "U" shaped elements having first and second longitudinal lengths, respectively, the second longitudinal length being substantially less than the first longitudinal length. The substantially "U" shaped elements of the first and second sets of curvilinear elements are connected to one another to define a substantially sinusoidal pattern extending circumferentially along the segments, the sinusoidal pattern having an alternating amplitude defined by the first and second longit:udinal lengths. Alternatively, the substantially "U"
shaped elements may have first and second thicknesses or diameters, wherein the first thickness is substantially less than the second thickness.
In addition, the connector preferably includes a curve extending at least partially circumferentially along the circumference defined by the plurality of segments. More preferably, the connector defines a sinusoidal shape adapted to extend and campress axially substantially evenly when the adjacent segments are subjected to a predetermined bending force. Although the connector may extend and compress, the connector preferably does not deform substantially when the stmt is expanded, i.e., the connector remains substantially stationary and distinct from the adjacent segments and does not become part of the cellular structure itself.
Furthermore, the connector preferably includes a pair of connectors located opposite one another on the circumference for fa~~ilitating articulation of the adjacent segments substantially transverse about the longitudinal axis.
Thus, an important aspect of the present invention is to provide a stent that includes a substantially tubular member plastically deformable between contracted and enlarged conditions, including a plurality of cylindrical segments and connectors for facilitating articulation of the adjacent cylindrical segments about the longitudinal axis, for example, when the stmt is bent during delivery in a curved body passage and/or that substantially uniformly scaffolds the wall of the body passage.
In another aspect, the present invention is directed to a device for delivering an expandable stmt, such as that previously described, to a site within a patient's body.
The device includes an elongate member having proximal and distal ends, a nose cone on the distal end, and an expandable member on the elongate member proximate to the nose cone for receiving an expandable stmt thereon. The nose cone has a widened portion and a tapered distal tip to facilitate insertion along a body passage.
The stent delivery device also preferably includes an outer sheath slidable over the elongate member, the outer sheatr~ including a lumen for receiving the elongate member theret.hrough. The outer sheath includes a distal end having a diameter substantially similar to the widened portion of the nose cone for substantially sealing the lumen when the distal. end of the outer sheath engages the widened portion of the nose cone and/or to provide a substantially smooth transition therebetween to facilitate advancement of the stmt delivery device through the body passage. In addition, the outer sheath may include one or more perfusion holes extending between an outer surface of the outer sheath and the lumen for allowing continued perfusion of fluid along the body passage during scent delivery. The nose cone may also include perfusion holes proximal and distal of the widened portion.
I:n addition, the stmt delivery device also may include a shoulder on the elongate member proximate the expandable member. The shoulder preferably has a blunt distal edge for engaging a proximal end of an expandable stmt received on the expandable member to prevent substantial proximal movement of the expandable scent. The shoulder may also inclucie a substantially tapered proximal edge to facilitate withdz:awal of the elongate member from a body passage.
The device may be used in a method for implanting a prosthesis or stmt within a curved region of a body passage, the stmt including a plurality of cylindrical segments and a plurality of connectors extending between adjacent segments, as previously described. The stmt is placed in a contracted condition on a distal end of a stent delivery device, the distal end of the stent delivery device is advanced along the body passage, and the stmt is positioned within the curved region. The stent is then expanded, first to an intermediate enlarged condition to substantially eliminate localized radial forces, and then further to a final enlarged condition, the circumferential pattern of alternating curvilinear elements expanding substantially evenly about a circumference of the stent to scaffold the curved region. The stmt delivery catheter may then be withdrawn from the body passage, leaving the stent substantially permanently implanted within the curved region.
More preferably, the stent delivery device is used in a method for delivering an expandable stmt to a selected delivery site within a patient's body, for example, within the cardiovascular system. The stmt delivery device includes an elongate member having an expandable member on its distal end, a tapered nose cone, a proximal shoulder, and an outer sheath for slidably receiving the elongate member therein. The stmt is placed in a contracted condition on the expandable member, and the elongate member is inserted into the outer sheath to cover the stent. The distal end of the elongate member is advanced along a body passage within the patient's body, and the stmt is positioned at the selected delivery site. The outer sheath is withdrawn proximally to expose the stmt at the selected delivery site, and the stmt is expanded to an enlarged condition with the expandable member. The method described may be particularly useful for creating and/or maintaining a channel connecting a vein to an adjacent artery, preferably in the coronary system.
Other objects and features of the present invention will become apparent from consideration of the following description taken in conjunctian with the accompanying drawings.
BRIEF DESCRIPTION OF THE DRAWINGS
FIG. lA is a side view of a preferred embodiment of an unexpanded stent in accordance with the present invention.
F'IG. 1B is a side view of the stent of FIG. lA expanded to a first enlarged condition.
FIG. 1C is a side view of the stmt of FIG. 1A expanded to a second enlarged condition.
FIG. 2 is a flat view of the unexpanded stmt of FIG. 1 unrolled to more clearly show the configuration of the stmt elements.
F'IG. 3A is a perspective view of the stmt of FIG. 1B, expanded to the first enlarged condition.
F'IG. 3B is a perspective view of the stmt of FIG. 1B, with a proximal portion of the scent further expanded to a second enlarged condition.
F'IG. 4A is a cross-sectional side view of two adjacent blood vessels with a guide wire placed through a channel between the vessels.
FIGS. 4B and 4C show a balloon catheter delivered over the guide wire and positioned between the vessels of FIG.
4A, with the balloon collapsed for delivery and expanded for dilating the channel, respectively.
fIG. 4D shows a stmt delivery device being delivered over the guide wire, after withdrawal of the balloon catheter of FIGS. 4B and 4C.
FIGS. 4E and 4F show a stmt being positioned across the channel of FIG. 4D with the assistance of markers on the stmt delivery device, and an outer sheath being retracted to expose the stent, respectively.
FIGS. 4G and 4H show a balloon on the stmt delivery device of FIGS. 4E and 4F being inflated to expand the scent to its enlarged condition, and being deflated to facilitate withdrawal of the stmt delivery device, respectively.
F'IG. 4I shows the stmt delivery device of FIGS. 4G and 4H being withdrawn, leaving the scent in place across the channel.
WO 99/62430 PC'T/US99/10645 FIG. 5A is a side view of a preferred embodiment of a stmt delivery device, with a stmt placed in a collapsed condition over a balloon on the stmt delivery device.
E'IG. 5B is a cross-sectional side view the stmt
In an effort to provide a uniform enlarged condition, stems generally have a substantially uniform pattern extending about the circumference of the individual segments, and generally have segments of equal lengths.
Because of the uneven radial forces which may be encountered during expansion, however, these stents may not expand substantially uniformly despite the intended result of their uniform designs. This problem may be further exacerbated because individual stems are generally intended to be expanded to a range of potential enlarged sizes, for example, between 3.0 mm and 5.5 mm. While at the upper end of the range, the radial forces may become more even and expand the stmt more uniformly, the stmt may be prone to uneven expansion at the lower end of the range, where localized heightened radial forces are more likely to occur.
Accordingly, it is believed that there is a need for stems which more effectively scaffold the vessel wall and/or which substantially evenly engage vessel walls, particularly within curved vessel regions, and for methods and systems using such stents.
SUMMARY OF THE INVENTION
The present invention is directed to implantable devices for use within body passages, particularly within the cardiovascular system, and more particularly to deformable prostheses for implantation within and/or between S
blood vessels, and to methods of using them to create and/or maintain connections between adjacent blood vessels.
In one aspect of the present invention, a stent is provided for implantation within a body passage that includes a plurality of expandable segments defining a circumference and a longitudinal axis, and a connector extending between adjacent segments. Each segment includes an alt:ernating pattern of curvilinear elements extending about the circumference.
l~n a preferred embodiment, the alternating pattern includes a first set of curvilinear elements having a first resistance to expansion and a second set of curvilinear elements having a second resistance to expansion substantially higher than the first resistance to expansion.
Consequently, each segment is expandable between a contracted condition, a first or intermediate expanded condition, and a second or final expanded condition.
Preferably, the first expanded condition is achieved when a radial force exceeding the first resistance to expansion is applied to the segment, and the second expanded condition is achieved when a radial force exceeding the second resistance to expansion is applied to the segment.
More preferably, the first and second sets of curviJ_inear elements are substantially "U" shaped elements having first and second longitudinal lengths, respectively, the second longitudinal length being substantially less than the first longitudinal length. The substantially "U" shaped elements of the first and second sets of curvilinear elements are connected to one another to define a substantially sinusoidal pattern extending circumferentially along the segments, the sinusoidal pattern having an alternating amplitude defined by the first and second longit:udinal lengths. Alternatively, the substantially "U"
shaped elements may have first and second thicknesses or diameters, wherein the first thickness is substantially less than the second thickness.
In addition, the connector preferably includes a curve extending at least partially circumferentially along the circumference defined by the plurality of segments. More preferably, the connector defines a sinusoidal shape adapted to extend and campress axially substantially evenly when the adjacent segments are subjected to a predetermined bending force. Although the connector may extend and compress, the connector preferably does not deform substantially when the stmt is expanded, i.e., the connector remains substantially stationary and distinct from the adjacent segments and does not become part of the cellular structure itself.
Furthermore, the connector preferably includes a pair of connectors located opposite one another on the circumference for fa~~ilitating articulation of the adjacent segments substantially transverse about the longitudinal axis.
Thus, an important aspect of the present invention is to provide a stent that includes a substantially tubular member plastically deformable between contracted and enlarged conditions, including a plurality of cylindrical segments and connectors for facilitating articulation of the adjacent cylindrical segments about the longitudinal axis, for example, when the stmt is bent during delivery in a curved body passage and/or that substantially uniformly scaffolds the wall of the body passage.
In another aspect, the present invention is directed to a device for delivering an expandable stmt, such as that previously described, to a site within a patient's body.
The device includes an elongate member having proximal and distal ends, a nose cone on the distal end, and an expandable member on the elongate member proximate to the nose cone for receiving an expandable stmt thereon. The nose cone has a widened portion and a tapered distal tip to facilitate insertion along a body passage.
The stent delivery device also preferably includes an outer sheath slidable over the elongate member, the outer sheatr~ including a lumen for receiving the elongate member theret.hrough. The outer sheath includes a distal end having a diameter substantially similar to the widened portion of the nose cone for substantially sealing the lumen when the distal. end of the outer sheath engages the widened portion of the nose cone and/or to provide a substantially smooth transition therebetween to facilitate advancement of the stmt delivery device through the body passage. In addition, the outer sheath may include one or more perfusion holes extending between an outer surface of the outer sheath and the lumen for allowing continued perfusion of fluid along the body passage during scent delivery. The nose cone may also include perfusion holes proximal and distal of the widened portion.
I:n addition, the stmt delivery device also may include a shoulder on the elongate member proximate the expandable member. The shoulder preferably has a blunt distal edge for engaging a proximal end of an expandable stmt received on the expandable member to prevent substantial proximal movement of the expandable scent. The shoulder may also inclucie a substantially tapered proximal edge to facilitate withdz:awal of the elongate member from a body passage.
The device may be used in a method for implanting a prosthesis or stmt within a curved region of a body passage, the stmt including a plurality of cylindrical segments and a plurality of connectors extending between adjacent segments, as previously described. The stmt is placed in a contracted condition on a distal end of a stent delivery device, the distal end of the stent delivery device is advanced along the body passage, and the stmt is positioned within the curved region. The stent is then expanded, first to an intermediate enlarged condition to substantially eliminate localized radial forces, and then further to a final enlarged condition, the circumferential pattern of alternating curvilinear elements expanding substantially evenly about a circumference of the stent to scaffold the curved region. The stmt delivery catheter may then be withdrawn from the body passage, leaving the stent substantially permanently implanted within the curved region.
More preferably, the stent delivery device is used in a method for delivering an expandable stmt to a selected delivery site within a patient's body, for example, within the cardiovascular system. The stmt delivery device includes an elongate member having an expandable member on its distal end, a tapered nose cone, a proximal shoulder, and an outer sheath for slidably receiving the elongate member therein. The stmt is placed in a contracted condition on the expandable member, and the elongate member is inserted into the outer sheath to cover the stent. The distal end of the elongate member is advanced along a body passage within the patient's body, and the stmt is positioned at the selected delivery site. The outer sheath is withdrawn proximally to expose the stmt at the selected delivery site, and the stmt is expanded to an enlarged condition with the expandable member. The method described may be particularly useful for creating and/or maintaining a channel connecting a vein to an adjacent artery, preferably in the coronary system.
Other objects and features of the present invention will become apparent from consideration of the following description taken in conjunctian with the accompanying drawings.
BRIEF DESCRIPTION OF THE DRAWINGS
FIG. lA is a side view of a preferred embodiment of an unexpanded stent in accordance with the present invention.
F'IG. 1B is a side view of the stent of FIG. lA expanded to a first enlarged condition.
FIG. 1C is a side view of the stmt of FIG. 1A expanded to a second enlarged condition.
FIG. 2 is a flat view of the unexpanded stmt of FIG. 1 unrolled to more clearly show the configuration of the stmt elements.
F'IG. 3A is a perspective view of the stmt of FIG. 1B, expanded to the first enlarged condition.
F'IG. 3B is a perspective view of the stmt of FIG. 1B, with a proximal portion of the scent further expanded to a second enlarged condition.
F'IG. 4A is a cross-sectional side view of two adjacent blood vessels with a guide wire placed through a channel between the vessels.
FIGS. 4B and 4C show a balloon catheter delivered over the guide wire and positioned between the vessels of FIG.
4A, with the balloon collapsed for delivery and expanded for dilating the channel, respectively.
fIG. 4D shows a stmt delivery device being delivered over the guide wire, after withdrawal of the balloon catheter of FIGS. 4B and 4C.
FIGS. 4E and 4F show a stmt being positioned across the channel of FIG. 4D with the assistance of markers on the stmt delivery device, and an outer sheath being retracted to expose the stent, respectively.
FIGS. 4G and 4H show a balloon on the stmt delivery device of FIGS. 4E and 4F being inflated to expand the scent to its enlarged condition, and being deflated to facilitate withdrawal of the stmt delivery device, respectively.
F'IG. 4I shows the stmt delivery device of FIGS. 4G and 4H being withdrawn, leaving the scent in place across the channel.
WO 99/62430 PC'T/US99/10645 FIG. 5A is a side view of a preferred embodiment of a stmt delivery device, with a stmt placed in a collapsed condition over a balloon on the stmt delivery device.
E'IG. 5B is a cross-sectional side view the stmt
5 delivery device of FIG. 5A.
E'IG. 6A is a cross-sectional side view of another preferred embodiment of a stmt delivery device with a nose cone, a backstop, and an outer sheath.
FIG. 6B is a cross-sectional side view of the distal 10 end of- the stent delivery device of FIG. 6A, with the outer sheath substantially engaging the nose cone.
E'IG. 6C is an alternative embodiment of the stent delivery device of FIG. 6B, with a tactile indicator protrusion on the outer sheath.
fIG. 6D is another alternative embodiment of the stmt delivery device of FIG. 6B, with a dilation balloon on the outer sheath.
E'IG. 7A is a side view of another preferred embodiment of a stmt delivery device, similar to FIG. 6, with a plurality of perfusion holes through the outer sheath and the nose cone.
E'IG. 7B is a detail of the distal end of the stmt delivery device of FIG. 7A, showing fluid flow through the perfusion holes.
E'IG. 7C is a side view of the stmt delivery device of FIG. TA placed between two adjacent blood vessels.
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS
Turning now to the drawings, FIGS. 1-3 show a preferred embodiment of an implantable prosthesis or stmt 10 in accordance with the present invention. Generally, the stent 10 includes a plurality of expandable cylindrical segments or "cells" 12 and a plurality of articulating connectors 14 which extend between adjacent cells 12.
WO 99/b2430 PCT/US99/10645 Preferably, the stent 10 is an initially solid tubular member, defining a longitudinal axis 16 and a circumference 18, that is preferably formed from a substantially plastically deformable material, such as stainless steel Type :316L, tantalum, MP35N cobalt alloy, or Nitinol. The walls of the tubular member are selectively removed by high precision cutting, e.g. laser cutting, chemical etching, water jet cutting or standard tool machining, to provide the pattern of cells 12 and connectors 14 described in detail below. Alternatively, the stem may be formed from a flat sheet of material that is rolled and axially fused together after creating the pattern of cells 12 and connectors 14.
With particular reference to FIG. 2, each cell 12 includes an alternating circumferential pattern of curvilinear elements or struts 20 which extends about the circumference 18. Preferably, the alternating pattern of curvilinear elements 20 includes a first set of curvilinear elements 22, having a first resistance to expansion, that alternates with a second set of curvilinear elements 24, having a second resistance to expansion that is substantially higher than that of the first set of curvilinear elements 22. The first and second resistances to expansion correspond to the resistance of the curvilinear elements 22, 24 to plastic deformation, i.e., once first and second plastic yield strengths of the curvilinear elements 22, 24., respectively, are exceeded. Alternatively, more than t:wo sets of curvilinear elements may be provided in the circumferential pattern, if the sets are alternated to provide a cyclical pattern about the circumference 18.
More preferably, the first and second sets of curvilinear elements 22, 24 are substantially "U" shaped elements, extending substantially parallel to the longitudinal axis 16, connected to one another to form a continuous alternating amplitude sinusoidal or "zigzag"
segment that extends about the circumference 18 of the cells 12. The first set of curvilinear elements 22 has a first longitudinal length or "amplitude" 26 that is substantially longer than a second longitudinal length or amplitude 28 of the second set of curvilinear elements 24, thereby providing a longer relative lever arm that results in the lower resistance to radial expansion, as will be appreciated by those skilled in the art. In a preferred form, the first longitudinal length is about 0.045 inches, and the second longitudinal length is about half the first longitudinal length..
In an alternative form, the first and second sets of curvilinear elements 22, 24 may have similar longitudinal lengths, but may have different thicknesses or diameters (not shown). For example, the first set of curvilinear elements may have a first thickness that is substantially smaller than a second thickness of the second set of curvilinear elements, thereby providing the first and second resistances to expansion, respectively. Alternatively, a combination of different shapes, lengths and/or thicknesses may be provided for the first and second set of curvilinear elements that result in the first and second resistances to expansion, as will be appreciated by those skilled in the art.
I~ue to the differences in resistances to expansion of the first and second sets of curvilinear elements 22, 24, the cells 12 may be expandable between a contracted condition (FIG. lA), an intermediate or first expanded condition (FIG. 1B), and a final or second expanded condition (FIG. 1C). The first expanded condition is achieved when a radial force at least as great as the first plastic yield strength is applied to the cells 12, and the second expanded condition is achieved when a radial force at least as great as the second plastic yield strength is applied to the cells 12, as is described more particularly below.
WO 99/b2430 PCT/US99/10645 Extending between the cells 12, the connectors 14 generally include a curve that extends at least partially circumferentially along the circumference 18 of the stent 10, i.e., substantially transverse to the longitudinal axis 16. In a preferred embodiment, the connectors 14 define a sinusoidal shape 30. The sinusoidal shape 30 is adapted to expand and contract substantially evenly parallel to the longitudinal axis 16 when the adjacent cells 12 are subjected to bending.
In addition, the sinusoidal shape 30 also maximizes surface engagement of a body passage. The transverse porticms 30a, 30b extend substantially transversely with respect to the longitudinal axis 31, thereby providing additional circumferential scaffolding to minimize gaps circumferentially between the connectors 14 which may otherwise result due to the smaller length of the second set of curvilinear elements 24.
F?referably, the connectors 19 are provided in pairs located opposite one another about the circumference 18 of the cells 12, and more preferably four connectors 14 are provided that are evenly spaced about the circumference 18 between each pair of adjacent cells 12. When the stmt 10 is subjected to bending, the pairs of connectors 14 facilitate articulation of the adjacent cells 12, thereby resulting in a substantially uniform cross-section interior lumen 32 within the stmt 10 that substantially scaffolds the vessel wall and minimizes the creation of gaps between adjacent cells 12.
When the stmt 10 is bent substantially transversely with respect to the longitudinal axis 16, as shown in FIGS.
3A and 3B, it is preferred that an outer radiused portion 36 of the stmt 10 extend longitudinally and an inner radiused portion 34 compress longitudinally to minimize any overall change in length of the stent 10. The sinusoidal shape 30 of the pair of connectors 14 facilitates this by providing a WO 99/b2430 PCT/US99/10645 similar resistance to deformation when subjected to either tensile or compressive forces. Thus, a pair of connectors 14 on the outer and inner portions 34, 36 of a bend may extend and compress longitudinally substantially evenly, thereby facilitating articulation of the stmt 10 substantially evenly about the longitudinal axis 16 and substantially eliminating the creation of gaps between the adjacent cells 12.
The substantially "S" shape of the stmt 10 shown in FIGS. 3A and 3B may be a particularly useful configuration for the final enlarged condition. In this configuration, the stmt 10 may be used to maintain a channel between adjacent body passages, such as adjacent blood vessels (not shown), as described further below. More particularly, as shown in FIG. 3B, the stent 10 may be expanded to the first enlarged condition on a distal end 10a, and to the second enlarged condition on a proximal end lOb to facilitate placement between adjacent blood vessels having different diameters, e.g. between an artery and a vein, respectively (not shown). Additional information on procedures for creating and/or maintaining channels between adjacent body passages may be found in U.S. patent application Serial No.
08/970,694 filed November 14, 1997, the disclosure of which is expressly incorporated herein by reference.
Returning to the cells 12, the alternating pattern 20 of curvilinear elements described above is an important feature of a stmt 10 in accordance with the present invention, which may be illustrated by generally describing the deployment of the stent 10. The stmt 10 is delivered to a selected delivery site within a body passage, such as a blood vessel (not shown), using a stmt delivery device, such as that shown in FIGS. 5A and 5B and designated as 100.
The stent delivery device 100 includes an elongate catheter body or tubular member 102 having a distal end 104 adapted for insertion into a body passage.
A balloon 108 or other expandable member is attached to or otherwise provided on the catheter body 102, preferably with a marker 106, such as a radiopaque marker, on the catheter body 102 in a predetermined relationship with the 5 balloon 108. The balloon 108 is preferably formed from an inelastic material, such as polyethylene, that expands to a diameter preselected to correspond to the diameter of the body passage into which the stmt 10 is to be implanted.
Because of its inelasticity, the uninflated balloon 108 is 10 typically wrapped around the elongate member 102, e.g., by rolling the balloon 108 circumferentially.
The stent 10 is compressed over the balloon 108, and delivered during a surgical procedure, such as the preferred method described below. Once the stmt 10 is advanced and 15 properly positioned at the delivery site, the balloon 108 is inflated to expand the cells 12 of the stmt 10 (not shown in FIGS. 5A and 5B). As the balloon 108 inflates, it may not unwrap substantially uniformly, causing the radial forces applied to the cells 12 to be initially localized, i.e., certain portions of the cells 12 may be expanded more than others.
E3ecause the first set of curvilinear elements 22 (not shown in FIGS. 5A and 5B) of the cells 12 has a lower resistance to expansion than the second set of curvilinear elements 24, the first set of curvilinear elements 22 expands more quickly than the second set of curvilinear elements 29, thereby expanding the cells 12 to their intermediate enlarged condition (FIG. 1B). After the balloon 108 is substantially unwrapped, it may be inflated further, thereby applying a substantially uniform radial force to the cells 12. When this substantially uniform radial_ force is applied to the alternating resistances to expansion of the first and second sets of curvilinear elements 22, 29, the radial force of the balloon 108 is distributed substantially circumferentially evenly about the circumference of the cells 12, thereby expanding the cells 12 to the final enlarged condition (see FIG. 1C) while substantially eliminating localized over-expansion that can create gaps within the cells 12.
I:n addition, although the connectors 14 may extend and compress as the adjacent cells 12 are expanded, e.g., within a curved body passage, the connectors 14 preferably do not deform substantially. Stated differently, the connectors 14 preferably remain substantially stationary and distinct from the adjacent segments 12, i.e., retaining a substantially sinusoidal shape, and do not become part of the cellular structure of the stmt 10.
Turning to FIGS. 4A-4I and 6A-6D, a system and method for delivering a stmt 10 in accordance with the present invention is illustrated. In a preferred embodiment, shown particularly in FIG. 6A, a stent delivery device 200 for delivering an expandable stmt 10 is provided, which includes an elongate catheter body 202 with an expandable balloon 208, a nose cone 212, a shoulder 216 thereon, and an outer sheath 220. The catheter body 202 has a proximal end 203, a. distal end 204, and a lumen 210 extending therebetween for directing the catheter body 202 over a guide wire 110 (FIGS. 4A-4I). The materials and dimensions of the: catheter body 202 are otherwise similar to conventional catheter devices, as will be appreciated by those skilled in the art.
The nose cone or dilator 212 is attached to the distal end 204 of the catheter body 202, and has a tapered distal tip 21.6 to facilitate advancement along a body passage and/or to dilate partially occluded regions of the body passage. The nose cone 212 may be provided from substantially flexible and or resilient material, such as PebaxC>, polyurethane, polyethylene, or nylon, adapted to minimize damage to tissue during advancement of the stent delivery device 200 within the body passage. The nose cone 212 has a widened portion 214, preferably with a diameter of not mare than about 6 French, thereby allowing percutaneous insertion into a blood vessel, such as into a patient's vasculature. The nose cone 212 may have a tapered proximal end 218, or alternatively a substantially blunt proximal end (not shown) for engaging the distal edge 36 of the stmt 10 to prevent substantial distal movement of the stmt 10 with respect to the catheter body 202.
The balloon 208 is attached to the catheter body 202 proximate to the nose cone 212. The balloon 208 preferably has an annular shape that is formed from a substantially inelastic material, such as polyethylene or nylon, and preferably has a predetermined inflated diameter selected to correspond to the size of the stmt 10 in its enlarged condition and/or to the body passage into which the scent 10 is to be implanted, and length selected to correspond to the length of the stent 10, as will be appreciated by those skilled in the art. The interior of the balloon 208 communicates with an inflation lumen (not shown) which extends proximally from the distal end 204 of the catheter body 202 to a source of inflation media, such as saline (not shown). Alternatively, other inflatable or mechanically expandable members may be provided instead of the balloon 208.
The shoulder or backstop 213 is provided on the catheter body proximate the balloon 208. The shoulder 213 has a substantially blunt distal edge 214 for engaging a proximal end 36 of the stmt 10 received on the balloon 208 to prevent substantial proximal movement of the stmt 10.
The shoulder 213 also preferably has a tapered proximal edge 216 to facilitate withdrawal of the catheter body 202 from within a body passage. The shoulder 213 may be integrally formed as part of the catheter body 202 or it may be a separate attached member.
'.rhe catheter body 202 may also include one or more markers, such as the radiopaque marker 206, thereon. The marker 206 preferably has a predetermined relationship with the balloon 208, and consequently to the stmt 10 placed thereon, to facilitate positioning of the stent 10 at the delivery site. For example, the marker 206 may be placed at a midpoint of the balloon 208 as shown, thereby allowing the stmt 10 to be centered across a body passage.
Alternatively, a marker may be provided adjacent to either end of the balloon 208, i.e. adjacent the proximal end 34 and/or the distal end 36 of the stent. In a further alternative, the nose cone 212 and/or the shoulder 213 may be provided from a radiopaque material or may be marked at a predei~ermined location thereon.
The outer sheath 220 is an elongate member having a proxirnal end 222, a distal end 224, and a lumen 226 therein, that is slidable over the catheter body 202, i.e., the cathei~er body 202 may be slidably received within the lumen 226 in the outer sheath 220. Preferably, the distal end 229 of the outer sheath 220 is tapered to facilitate advancement along a body passage, and more preferably, the distal end 224 has an inner diameter similar to the widened portion 214 of the nose cone 212. Thus, when the catheter body 202 is received within the outer sheath 220, the distal end 224 may engage the widened portion 214 to provide a substantially smooth surface which may facilitate advancement of the stmt delivery device 200 through a body passage. In particular, the resulting smooth surface may facilitate advancement of the nose cone 212 and outer sheath 220 through a channel created between two adjacent blood vessels, with minimized risk of snagging or getting caught on loose tissue in the channel. In addition, the outer sheath 220 may engage the nose cone 212 to substantially seal the lumen 224 and thereby prevent fluid contact with the stent 10 until exposed at the delivery site.
'The stmt delivery device 200 may also include a handle or control mechanism 230 on the proximal end 203 of the catheter body 202. The handle 230 may include an outer housing 232 to which the proximal end 203 of the catheter body 202 is fixed, and a slider 234 slidable with respect to the housing 232, i.e., within a cavity 236 therein. The proximal end 222 of the outer sheath 220 may be attached to the slider 234, such that when a thumb drip 238 or other slider control is engaged and drawn proximally, the outer sheath 220 may be withdrawn proximally, for example, to expose the balloon 208 when a stent 10 is initially placed thereon or to expose the stmt 10 at the delivery site.
With particular reference to FIGS. 4A-4I and 6A, the stent delivery device 200 may be used in a method for creating and/or maintaining a channel between adjacent body passages, such as a channel 262 between a coronary vein 252 and a coronary artery 254. A guide wire 110 is percutaneously introduced into a passage in a patient's body, such as a femoral vein, advanced into the coronary vein 252, and placed through the intervening tissue 260 into the adjacent coronary artery 254 to provide a channel 262 (FIG. 4A).
A balloon catheter 280 is advanced over the guide wire 110 until a marker 284 on the balloon catheter 280 is positioned in a predetermined relationship with the channel 262, e.g., the marker 284 may be centered under a balloon 282 on the balloon catheter 280 (FIG. 4B). The balloon 282 is then inflated to dilate the channel 262, i.e., to push the surrounding tissue 260 adjacent the channel 262 away and provide a cross-section sufficiently large to allow substantially unimpaired blood flow between the artery 254 and the vein 252 (FIG. 4C). The balloon 280 may then be deflated, and the balloon catheter 280 withdrawn over the guide wire 110 and out of the body.
Alternatively, other methods may be used to enlarge the channel 262 instead of using the balloon catheter 280. For example, the channel 262 may be debulked by removing intervening tissue 260 using energy, such as laser or radio 5 frequE:ncy (RF) energy, or by cutting or slicing through the intervening tissue 260, with over-the-guide wire instruments, until a desired size channel 262 is produced.
In further alternatives, other dilation devices may be used, such as mechanically expandable members, or the nose cone 10 212 of: the stmt delivery catheter 200, as described below.
A stent 10 having a predetermined length and enlarged condition diameters is selected to correspond with the configuration of the channel 262, the artery 254 and/or the vein 252. The stmt 10 may be preselected if the delivery 15 site is known prior to the commencement of the procedure, or the st:ent 10 may be selected once the site for the channel 262 i~> selected during the course of the procedure. The stmt 10 is then placed on a stmt delivery device 200, as shown in FIG. 6A. Generally, the stmt delivery device 200 20 is selected to correspond to the selected stent 10 and delivery site, i.e., based on the diameter of the catheter body 202, the inflated balloon 208 and/or the outer sheath 220.
The balloon 208 may be rolled or otherwise wrapped around the catheter body 202, and the stent, in its contracted condition, is placed over the balloon 208, for example, by manually compressing the stem 10 onto the ballot>n 208. The outer sheath 220 may then be advanced over the catheter body 202 until its distal end 229 substantially engages the nose cone 212, thereby substantially sealing the stent 10 within the lumen 226 in the outer sheath 220.
Alternatively, the stmt 10 may be sufficiently secured to the catheter body 202 such that the stent 10 may be delivered without the outer sheath 220, as shown, for WO 99/b2430 PCT/US99/10645 example, in FIGS. 5A and 5B, as will be appreciated by those skilled in the art.
The stmt delivery device 200 is then advanced over the guide wire 110 until the nose cone 212 passes through the channel 262 (FIG. 4D). The tapered distal tip 216 of the nose cone 212 facilitates the advancement of the stent delivery catheter 200 through the channel 262. The widened portion 214 of the nose cone 212 may have a size larger than the channel 262 to further dilate the channel 262 as the nose cone 212 is advanced therethrough. Alternatively, the nose cone 212 may be used to dilate the channel 262 in place of the balloon catheter 280. For example, as the nose cone 212 is advanced through the channel 262, the intervening tissue 260 may be pushed substantially away to dilate the channel 262, although it may be necessary to withdraw and advance the nose cone 212 multiple times to effectively dilate the channel 262.
In a further alternative, shown in FIG. 6D, the outer sheath 220 may include a dilation balloon 228 proximate its distal end 224. The dilation balloon 228 may be similar to the dilation balloon 280 described previously, but attached around the outer sheath 220,preferably such that the outer sheath 220 and unexpanded balloon 228 have a diameter of about twelve French or less. When the outer sheath 220 and the nose cone 212 are advanced and contact the undilated channel 262, or other partial obstruction, the balloon 228 may be inflated to open the body passage, and then deflated to allow further advancement or withdrawal.
The substantially smooth transition between the outer sheath 220 and the nose cone 212 is an important feature, which may minimize snagging or otherwise damaging the surrounding tissue 260 with the distal end 224 of the outer sheath 220. The smooth transition may also minimize catching the distal end 224 of the sheath 220 on loose tissue, a lesion or other constrictions in the body passage which may prevent further advancement of the stem catheter device 200.
In addition, because the outer sheath 220 substantially contains the stent 10 therein, the outer sheath 220 may also substantially minimize potential damage to vessel walls and the tissue 260 surrounding the channel 262, which may otherwise occur if an exposed stmt 10 is advanced therethrough. The outer sheath 220 may also substantially protect the stmt 10 itself during advancement over the guide wire 10. For example, the outer sheath 220 may protect the stent 10 from being dislodged from the stmt delivery device 200 prematurely, i.e., at a location other than the intended delivery site. Thus, the outer sheath 220 may substantially eliminate the risk of emergency surgical procedures to recover loose stems 10. Alternatively, if the outer sheath 220 is eliminated, the blunt edge 214 of the shoulder 213 and/or of the nose cone 212 may sufficiently protect the stmt 10, and prevent substantial axial movement of the stmt 10 as it is being advanced through the body passage.
The stent 10 may be positioned across the channel 262 with the aid of markers 206a, 206b. Preferably, the markers 206a, 206b are radiopaque, such that they may be viewed using fluoroscopy, or other external imaging methods. The markers 206a, 206b, shown in FIGS. 4E and 4F, for example, are provided on the nose cone 212 and the shoulder 213 to approximate the location of the proximal and distal edges 34, 36, respectively, of the stmt 10.
Alternatively, as shown in FIG. 6B, the outer sheath 220 may include one or more protrusions 227 for assisting in positioning the stmt 10 across the channel 262 (not shown in FIG. 6B). For example, the protrusion 227 may be a substantially rounded annulus molded directly onto the outer sheath 220 at a predetermined location with respect to the stem 10, e.g., at a midpoint thereof. The protrusion 227 may allow a user to detect when the outer sheath 220, and consequently the stent 10, are properly positioned across the channel 262, for example, based upon the resistance of the protrusion 227 to advancement beyond the channel 262, which :may substantially reduce the risk of over-advancing the stmt 10 beyond the channel 262.
Once the stmt 10 is properly positioned, the outer sheath 220 is withdrawn proximally to expose the stent 10 across the channel 262 (FIG. 4F). The balloon 208 may then be inflated, thereby expanding the stmt 10 to its enlarged condition (FIG. 4G). The inflation of the balloon 208 may be performed in two steps, first by inflating the balloon 208 to a first pressure, thereby expanding the stmt 10 to an intermediate enlarged condition and unwrapping the balloon 208 substantially from the catheter body 202 (not shown), and then by inflating the balloon 208 to a second higher pressure to fully expand the stmt 10 to its final enlarged condition (FIG. 9G).
T:he balloon 208 may then be deflated (FIG. 4H), and then the stmt delivery device 200 may be withdrawn over the guide wire 110 (FIG. 4I), leaving the stmt 10 substantially permanently implanted across the channel 262. Preferably, the stmt 10 substantially engages the lumens 256, 258 of the vein 252 and artery 254, respectively, as well as the tissue 260 surrounding the channel 262 to provide a substantially unimpaired passage for blood flow between the artery 254 and the vein 252.
In one form, the space between the cells 12 and/or between the curvilinear elements 22, 24 remains substantially open, thereby permitting fluid to pass through the circumference 18 of the stmt 10 and to continue flowing along the vessel and not cross through the channel 262 into the other vessel. For example, when a coronary vein is used to bypass an adjacent occluded coronary artery, it may be desirable to continue to allow some blood flow along the coronary artery to perfuse the occluded region.
Alternatively, a nonporous membrane (not shown) may be attached about the circumference 18 of the stent 10 to direct all fluid from the source vessel through the channel into t:he other vessel.
In an alternative method, because of differences in the diameters of the vein 252 and the artery 254, it may desirable to have the final diameter of the enlarged stent vary along its length, as shown in FIGS. 3B and 4H. For 10 example, the stmt 10 may be selected such that the first or intermediate enlarged condition corresponds to the diameter of the artery 254 and the second enlarged condition corresponds to the diameter of the vein 252. The balloon 208 may have a diameter that varies along its length, e.g., the diameter may be larger on a proximal portion of the balloon 208 (not shown), to facilitate proper expansion of the st:ent 10. Alternatively, the balloon 208 may be used to expand the stent 10 to the first enlarged condition, using the method previously described, and then a second balloon may be advanced over the guide wire 110 to expand specific cells 12 or portions of the stmt 10 to the second enlarged condition, as will be appreciated by those skilled in the art.
l.n another alternative, a portion of the stmt 10 may be provided from a self-expanding material, e.g., heat treated Nitinol, and another portion may be provided from a malleable as previously described. For example, it may be desirable to have the proximal end 10b automatically expand when deployed to engage one vessel, while the distal end l0a may be' selectively deformed to engage an adjacent vessel.
Prefei:ably, where the stent 10 is used to maintain a channel between a vein and an adjacent artery, the proximal end lOb may be self-expanding, thereby allowing the stmt 10 to automatically expand to engage the wall of the vein. The proximal end lOb of the stmt 10 may automatically enlarge to continuously engage the wall of the vein, thereby accommodating subsequent venous expansion which may occur over time as the vein is subjected to arterial pressure.
The distal end l0a may be plastically deformed, for example, 5 using a balloon catheter, to a desired enlarged condition, as described previously.
In another embodiment, particularly with regard to using the prosthesis 10 between two vessels to form an anastomosis therebetween, it may be desirable to form the 10 prosthesis 10 and the resulting connection in more ovular shape than is desired during simple intraluminal placement where the prosthesis 10 may be generally circular.
Elliptical connections in this particular application may promote a better physiologic response to the 15 implant, by lessening turbulence in the blood flow and imitating a more natural vessel condition.
Turning to FIGS. 7A-7C, an alternative embodiment of a stmt delivery device 300 is shown that provides continued blood perfusion during stmt delivery in accordance with 20 another aspect of the present invention. Most of the elements of this device are similar to the embodiment shown in FIG. 6A, with like elements having reference numbers increased by 100.
In particular, the stmt delivery device 300 includes a 25 catheter body 302, a nose cone 312, and an outer sheath 320.
The outer sheath 320 includes one or more perfusion holes 350 that extend from its outer wall to a lumen 326 for receiving the catheter body 302 therethrough, or to a separate lumen (not shown). The nose cone 312 also includes one or more perfusion holes 352, 354 proximal and distal to the widened portion 314, with a perfusion lumen 356 (shown in phantom in FIG. 7B) extending between them.
for example, as shown in FIG. 7C, the stent delivery device 300 may be positioned across a channel 262 between a vein 252 and an artery 254, for example during the stmt delivery method described above. The outer sheath 320 may substantially occlude the artery 254, such that without the perfusion holes 350, blood flow along the artery 254 would be substantially impaired. Because of the perfusion holes 350, 352, 354, however, blood may continue to travel along the artery 254, for example, first by entering the lumen 326 of the outer sheath 320 through the perfusion holes 350.
The blood may then enter the proximal or inlet perfusion holes 352 in the nose cone 312, pass through the perfusion lumen: 356, and then reenter the artery 254 through the distal_ or outlet perfusion holes 354 to continue downstream.
While the invention is susceptible to various modifications, and alternative forms, specific examples thereof have been shown in the drawings and are herein described in detail. It should be understood, however, that the invention is not to be limited to the particular forms or methods disclosed, but to the contrary, the invention is to cover all modifications, equivalents and alternatives falling within the spirit and scope of the appended claims.
E'IG. 6A is a cross-sectional side view of another preferred embodiment of a stmt delivery device with a nose cone, a backstop, and an outer sheath.
FIG. 6B is a cross-sectional side view of the distal 10 end of- the stent delivery device of FIG. 6A, with the outer sheath substantially engaging the nose cone.
E'IG. 6C is an alternative embodiment of the stent delivery device of FIG. 6B, with a tactile indicator protrusion on the outer sheath.
fIG. 6D is another alternative embodiment of the stmt delivery device of FIG. 6B, with a dilation balloon on the outer sheath.
E'IG. 7A is a side view of another preferred embodiment of a stmt delivery device, similar to FIG. 6, with a plurality of perfusion holes through the outer sheath and the nose cone.
E'IG. 7B is a detail of the distal end of the stmt delivery device of FIG. 7A, showing fluid flow through the perfusion holes.
E'IG. 7C is a side view of the stmt delivery device of FIG. TA placed between two adjacent blood vessels.
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS
Turning now to the drawings, FIGS. 1-3 show a preferred embodiment of an implantable prosthesis or stmt 10 in accordance with the present invention. Generally, the stent 10 includes a plurality of expandable cylindrical segments or "cells" 12 and a plurality of articulating connectors 14 which extend between adjacent cells 12.
WO 99/b2430 PCT/US99/10645 Preferably, the stent 10 is an initially solid tubular member, defining a longitudinal axis 16 and a circumference 18, that is preferably formed from a substantially plastically deformable material, such as stainless steel Type :316L, tantalum, MP35N cobalt alloy, or Nitinol. The walls of the tubular member are selectively removed by high precision cutting, e.g. laser cutting, chemical etching, water jet cutting or standard tool machining, to provide the pattern of cells 12 and connectors 14 described in detail below. Alternatively, the stem may be formed from a flat sheet of material that is rolled and axially fused together after creating the pattern of cells 12 and connectors 14.
With particular reference to FIG. 2, each cell 12 includes an alternating circumferential pattern of curvilinear elements or struts 20 which extends about the circumference 18. Preferably, the alternating pattern of curvilinear elements 20 includes a first set of curvilinear elements 22, having a first resistance to expansion, that alternates with a second set of curvilinear elements 24, having a second resistance to expansion that is substantially higher than that of the first set of curvilinear elements 22. The first and second resistances to expansion correspond to the resistance of the curvilinear elements 22, 24 to plastic deformation, i.e., once first and second plastic yield strengths of the curvilinear elements 22, 24., respectively, are exceeded. Alternatively, more than t:wo sets of curvilinear elements may be provided in the circumferential pattern, if the sets are alternated to provide a cyclical pattern about the circumference 18.
More preferably, the first and second sets of curvilinear elements 22, 24 are substantially "U" shaped elements, extending substantially parallel to the longitudinal axis 16, connected to one another to form a continuous alternating amplitude sinusoidal or "zigzag"
segment that extends about the circumference 18 of the cells 12. The first set of curvilinear elements 22 has a first longitudinal length or "amplitude" 26 that is substantially longer than a second longitudinal length or amplitude 28 of the second set of curvilinear elements 24, thereby providing a longer relative lever arm that results in the lower resistance to radial expansion, as will be appreciated by those skilled in the art. In a preferred form, the first longitudinal length is about 0.045 inches, and the second longitudinal length is about half the first longitudinal length..
In an alternative form, the first and second sets of curvilinear elements 22, 24 may have similar longitudinal lengths, but may have different thicknesses or diameters (not shown). For example, the first set of curvilinear elements may have a first thickness that is substantially smaller than a second thickness of the second set of curvilinear elements, thereby providing the first and second resistances to expansion, respectively. Alternatively, a combination of different shapes, lengths and/or thicknesses may be provided for the first and second set of curvilinear elements that result in the first and second resistances to expansion, as will be appreciated by those skilled in the art.
I~ue to the differences in resistances to expansion of the first and second sets of curvilinear elements 22, 24, the cells 12 may be expandable between a contracted condition (FIG. lA), an intermediate or first expanded condition (FIG. 1B), and a final or second expanded condition (FIG. 1C). The first expanded condition is achieved when a radial force at least as great as the first plastic yield strength is applied to the cells 12, and the second expanded condition is achieved when a radial force at least as great as the second plastic yield strength is applied to the cells 12, as is described more particularly below.
WO 99/b2430 PCT/US99/10645 Extending between the cells 12, the connectors 14 generally include a curve that extends at least partially circumferentially along the circumference 18 of the stent 10, i.e., substantially transverse to the longitudinal axis 16. In a preferred embodiment, the connectors 14 define a sinusoidal shape 30. The sinusoidal shape 30 is adapted to expand and contract substantially evenly parallel to the longitudinal axis 16 when the adjacent cells 12 are subjected to bending.
In addition, the sinusoidal shape 30 also maximizes surface engagement of a body passage. The transverse porticms 30a, 30b extend substantially transversely with respect to the longitudinal axis 31, thereby providing additional circumferential scaffolding to minimize gaps circumferentially between the connectors 14 which may otherwise result due to the smaller length of the second set of curvilinear elements 24.
F?referably, the connectors 19 are provided in pairs located opposite one another about the circumference 18 of the cells 12, and more preferably four connectors 14 are provided that are evenly spaced about the circumference 18 between each pair of adjacent cells 12. When the stmt 10 is subjected to bending, the pairs of connectors 14 facilitate articulation of the adjacent cells 12, thereby resulting in a substantially uniform cross-section interior lumen 32 within the stmt 10 that substantially scaffolds the vessel wall and minimizes the creation of gaps between adjacent cells 12.
When the stmt 10 is bent substantially transversely with respect to the longitudinal axis 16, as shown in FIGS.
3A and 3B, it is preferred that an outer radiused portion 36 of the stmt 10 extend longitudinally and an inner radiused portion 34 compress longitudinally to minimize any overall change in length of the stent 10. The sinusoidal shape 30 of the pair of connectors 14 facilitates this by providing a WO 99/b2430 PCT/US99/10645 similar resistance to deformation when subjected to either tensile or compressive forces. Thus, a pair of connectors 14 on the outer and inner portions 34, 36 of a bend may extend and compress longitudinally substantially evenly, thereby facilitating articulation of the stmt 10 substantially evenly about the longitudinal axis 16 and substantially eliminating the creation of gaps between the adjacent cells 12.
The substantially "S" shape of the stmt 10 shown in FIGS. 3A and 3B may be a particularly useful configuration for the final enlarged condition. In this configuration, the stmt 10 may be used to maintain a channel between adjacent body passages, such as adjacent blood vessels (not shown), as described further below. More particularly, as shown in FIG. 3B, the stent 10 may be expanded to the first enlarged condition on a distal end 10a, and to the second enlarged condition on a proximal end lOb to facilitate placement between adjacent blood vessels having different diameters, e.g. between an artery and a vein, respectively (not shown). Additional information on procedures for creating and/or maintaining channels between adjacent body passages may be found in U.S. patent application Serial No.
08/970,694 filed November 14, 1997, the disclosure of which is expressly incorporated herein by reference.
Returning to the cells 12, the alternating pattern 20 of curvilinear elements described above is an important feature of a stmt 10 in accordance with the present invention, which may be illustrated by generally describing the deployment of the stent 10. The stmt 10 is delivered to a selected delivery site within a body passage, such as a blood vessel (not shown), using a stmt delivery device, such as that shown in FIGS. 5A and 5B and designated as 100.
The stent delivery device 100 includes an elongate catheter body or tubular member 102 having a distal end 104 adapted for insertion into a body passage.
A balloon 108 or other expandable member is attached to or otherwise provided on the catheter body 102, preferably with a marker 106, such as a radiopaque marker, on the catheter body 102 in a predetermined relationship with the 5 balloon 108. The balloon 108 is preferably formed from an inelastic material, such as polyethylene, that expands to a diameter preselected to correspond to the diameter of the body passage into which the stmt 10 is to be implanted.
Because of its inelasticity, the uninflated balloon 108 is 10 typically wrapped around the elongate member 102, e.g., by rolling the balloon 108 circumferentially.
The stent 10 is compressed over the balloon 108, and delivered during a surgical procedure, such as the preferred method described below. Once the stmt 10 is advanced and 15 properly positioned at the delivery site, the balloon 108 is inflated to expand the cells 12 of the stmt 10 (not shown in FIGS. 5A and 5B). As the balloon 108 inflates, it may not unwrap substantially uniformly, causing the radial forces applied to the cells 12 to be initially localized, i.e., certain portions of the cells 12 may be expanded more than others.
E3ecause the first set of curvilinear elements 22 (not shown in FIGS. 5A and 5B) of the cells 12 has a lower resistance to expansion than the second set of curvilinear elements 24, the first set of curvilinear elements 22 expands more quickly than the second set of curvilinear elements 29, thereby expanding the cells 12 to their intermediate enlarged condition (FIG. 1B). After the balloon 108 is substantially unwrapped, it may be inflated further, thereby applying a substantially uniform radial force to the cells 12. When this substantially uniform radial_ force is applied to the alternating resistances to expansion of the first and second sets of curvilinear elements 22, 29, the radial force of the balloon 108 is distributed substantially circumferentially evenly about the circumference of the cells 12, thereby expanding the cells 12 to the final enlarged condition (see FIG. 1C) while substantially eliminating localized over-expansion that can create gaps within the cells 12.
I:n addition, although the connectors 14 may extend and compress as the adjacent cells 12 are expanded, e.g., within a curved body passage, the connectors 14 preferably do not deform substantially. Stated differently, the connectors 14 preferably remain substantially stationary and distinct from the adjacent segments 12, i.e., retaining a substantially sinusoidal shape, and do not become part of the cellular structure of the stmt 10.
Turning to FIGS. 4A-4I and 6A-6D, a system and method for delivering a stmt 10 in accordance with the present invention is illustrated. In a preferred embodiment, shown particularly in FIG. 6A, a stent delivery device 200 for delivering an expandable stmt 10 is provided, which includes an elongate catheter body 202 with an expandable balloon 208, a nose cone 212, a shoulder 216 thereon, and an outer sheath 220. The catheter body 202 has a proximal end 203, a. distal end 204, and a lumen 210 extending therebetween for directing the catheter body 202 over a guide wire 110 (FIGS. 4A-4I). The materials and dimensions of the: catheter body 202 are otherwise similar to conventional catheter devices, as will be appreciated by those skilled in the art.
The nose cone or dilator 212 is attached to the distal end 204 of the catheter body 202, and has a tapered distal tip 21.6 to facilitate advancement along a body passage and/or to dilate partially occluded regions of the body passage. The nose cone 212 may be provided from substantially flexible and or resilient material, such as PebaxC>, polyurethane, polyethylene, or nylon, adapted to minimize damage to tissue during advancement of the stent delivery device 200 within the body passage. The nose cone 212 has a widened portion 214, preferably with a diameter of not mare than about 6 French, thereby allowing percutaneous insertion into a blood vessel, such as into a patient's vasculature. The nose cone 212 may have a tapered proximal end 218, or alternatively a substantially blunt proximal end (not shown) for engaging the distal edge 36 of the stmt 10 to prevent substantial distal movement of the stmt 10 with respect to the catheter body 202.
The balloon 208 is attached to the catheter body 202 proximate to the nose cone 212. The balloon 208 preferably has an annular shape that is formed from a substantially inelastic material, such as polyethylene or nylon, and preferably has a predetermined inflated diameter selected to correspond to the size of the stmt 10 in its enlarged condition and/or to the body passage into which the scent 10 is to be implanted, and length selected to correspond to the length of the stent 10, as will be appreciated by those skilled in the art. The interior of the balloon 208 communicates with an inflation lumen (not shown) which extends proximally from the distal end 204 of the catheter body 202 to a source of inflation media, such as saline (not shown). Alternatively, other inflatable or mechanically expandable members may be provided instead of the balloon 208.
The shoulder or backstop 213 is provided on the catheter body proximate the balloon 208. The shoulder 213 has a substantially blunt distal edge 214 for engaging a proximal end 36 of the stmt 10 received on the balloon 208 to prevent substantial proximal movement of the stmt 10.
The shoulder 213 also preferably has a tapered proximal edge 216 to facilitate withdrawal of the catheter body 202 from within a body passage. The shoulder 213 may be integrally formed as part of the catheter body 202 or it may be a separate attached member.
'.rhe catheter body 202 may also include one or more markers, such as the radiopaque marker 206, thereon. The marker 206 preferably has a predetermined relationship with the balloon 208, and consequently to the stmt 10 placed thereon, to facilitate positioning of the stent 10 at the delivery site. For example, the marker 206 may be placed at a midpoint of the balloon 208 as shown, thereby allowing the stmt 10 to be centered across a body passage.
Alternatively, a marker may be provided adjacent to either end of the balloon 208, i.e. adjacent the proximal end 34 and/or the distal end 36 of the stent. In a further alternative, the nose cone 212 and/or the shoulder 213 may be provided from a radiopaque material or may be marked at a predei~ermined location thereon.
The outer sheath 220 is an elongate member having a proxirnal end 222, a distal end 224, and a lumen 226 therein, that is slidable over the catheter body 202, i.e., the cathei~er body 202 may be slidably received within the lumen 226 in the outer sheath 220. Preferably, the distal end 229 of the outer sheath 220 is tapered to facilitate advancement along a body passage, and more preferably, the distal end 224 has an inner diameter similar to the widened portion 214 of the nose cone 212. Thus, when the catheter body 202 is received within the outer sheath 220, the distal end 224 may engage the widened portion 214 to provide a substantially smooth surface which may facilitate advancement of the stmt delivery device 200 through a body passage. In particular, the resulting smooth surface may facilitate advancement of the nose cone 212 and outer sheath 220 through a channel created between two adjacent blood vessels, with minimized risk of snagging or getting caught on loose tissue in the channel. In addition, the outer sheath 220 may engage the nose cone 212 to substantially seal the lumen 224 and thereby prevent fluid contact with the stent 10 until exposed at the delivery site.
'The stmt delivery device 200 may also include a handle or control mechanism 230 on the proximal end 203 of the catheter body 202. The handle 230 may include an outer housing 232 to which the proximal end 203 of the catheter body 202 is fixed, and a slider 234 slidable with respect to the housing 232, i.e., within a cavity 236 therein. The proximal end 222 of the outer sheath 220 may be attached to the slider 234, such that when a thumb drip 238 or other slider control is engaged and drawn proximally, the outer sheath 220 may be withdrawn proximally, for example, to expose the balloon 208 when a stent 10 is initially placed thereon or to expose the stmt 10 at the delivery site.
With particular reference to FIGS. 4A-4I and 6A, the stent delivery device 200 may be used in a method for creating and/or maintaining a channel between adjacent body passages, such as a channel 262 between a coronary vein 252 and a coronary artery 254. A guide wire 110 is percutaneously introduced into a passage in a patient's body, such as a femoral vein, advanced into the coronary vein 252, and placed through the intervening tissue 260 into the adjacent coronary artery 254 to provide a channel 262 (FIG. 4A).
A balloon catheter 280 is advanced over the guide wire 110 until a marker 284 on the balloon catheter 280 is positioned in a predetermined relationship with the channel 262, e.g., the marker 284 may be centered under a balloon 282 on the balloon catheter 280 (FIG. 4B). The balloon 282 is then inflated to dilate the channel 262, i.e., to push the surrounding tissue 260 adjacent the channel 262 away and provide a cross-section sufficiently large to allow substantially unimpaired blood flow between the artery 254 and the vein 252 (FIG. 4C). The balloon 280 may then be deflated, and the balloon catheter 280 withdrawn over the guide wire 110 and out of the body.
Alternatively, other methods may be used to enlarge the channel 262 instead of using the balloon catheter 280. For example, the channel 262 may be debulked by removing intervening tissue 260 using energy, such as laser or radio 5 frequE:ncy (RF) energy, or by cutting or slicing through the intervening tissue 260, with over-the-guide wire instruments, until a desired size channel 262 is produced.
In further alternatives, other dilation devices may be used, such as mechanically expandable members, or the nose cone 10 212 of: the stmt delivery catheter 200, as described below.
A stent 10 having a predetermined length and enlarged condition diameters is selected to correspond with the configuration of the channel 262, the artery 254 and/or the vein 252. The stmt 10 may be preselected if the delivery 15 site is known prior to the commencement of the procedure, or the st:ent 10 may be selected once the site for the channel 262 i~> selected during the course of the procedure. The stmt 10 is then placed on a stmt delivery device 200, as shown in FIG. 6A. Generally, the stmt delivery device 200 20 is selected to correspond to the selected stent 10 and delivery site, i.e., based on the diameter of the catheter body 202, the inflated balloon 208 and/or the outer sheath 220.
The balloon 208 may be rolled or otherwise wrapped around the catheter body 202, and the stent, in its contracted condition, is placed over the balloon 208, for example, by manually compressing the stem 10 onto the ballot>n 208. The outer sheath 220 may then be advanced over the catheter body 202 until its distal end 229 substantially engages the nose cone 212, thereby substantially sealing the stent 10 within the lumen 226 in the outer sheath 220.
Alternatively, the stmt 10 may be sufficiently secured to the catheter body 202 such that the stent 10 may be delivered without the outer sheath 220, as shown, for WO 99/b2430 PCT/US99/10645 example, in FIGS. 5A and 5B, as will be appreciated by those skilled in the art.
The stmt delivery device 200 is then advanced over the guide wire 110 until the nose cone 212 passes through the channel 262 (FIG. 4D). The tapered distal tip 216 of the nose cone 212 facilitates the advancement of the stent delivery catheter 200 through the channel 262. The widened portion 214 of the nose cone 212 may have a size larger than the channel 262 to further dilate the channel 262 as the nose cone 212 is advanced therethrough. Alternatively, the nose cone 212 may be used to dilate the channel 262 in place of the balloon catheter 280. For example, as the nose cone 212 is advanced through the channel 262, the intervening tissue 260 may be pushed substantially away to dilate the channel 262, although it may be necessary to withdraw and advance the nose cone 212 multiple times to effectively dilate the channel 262.
In a further alternative, shown in FIG. 6D, the outer sheath 220 may include a dilation balloon 228 proximate its distal end 224. The dilation balloon 228 may be similar to the dilation balloon 280 described previously, but attached around the outer sheath 220,preferably such that the outer sheath 220 and unexpanded balloon 228 have a diameter of about twelve French or less. When the outer sheath 220 and the nose cone 212 are advanced and contact the undilated channel 262, or other partial obstruction, the balloon 228 may be inflated to open the body passage, and then deflated to allow further advancement or withdrawal.
The substantially smooth transition between the outer sheath 220 and the nose cone 212 is an important feature, which may minimize snagging or otherwise damaging the surrounding tissue 260 with the distal end 224 of the outer sheath 220. The smooth transition may also minimize catching the distal end 224 of the sheath 220 on loose tissue, a lesion or other constrictions in the body passage which may prevent further advancement of the stem catheter device 200.
In addition, because the outer sheath 220 substantially contains the stent 10 therein, the outer sheath 220 may also substantially minimize potential damage to vessel walls and the tissue 260 surrounding the channel 262, which may otherwise occur if an exposed stmt 10 is advanced therethrough. The outer sheath 220 may also substantially protect the stmt 10 itself during advancement over the guide wire 10. For example, the outer sheath 220 may protect the stent 10 from being dislodged from the stmt delivery device 200 prematurely, i.e., at a location other than the intended delivery site. Thus, the outer sheath 220 may substantially eliminate the risk of emergency surgical procedures to recover loose stems 10. Alternatively, if the outer sheath 220 is eliminated, the blunt edge 214 of the shoulder 213 and/or of the nose cone 212 may sufficiently protect the stmt 10, and prevent substantial axial movement of the stmt 10 as it is being advanced through the body passage.
The stent 10 may be positioned across the channel 262 with the aid of markers 206a, 206b. Preferably, the markers 206a, 206b are radiopaque, such that they may be viewed using fluoroscopy, or other external imaging methods. The markers 206a, 206b, shown in FIGS. 4E and 4F, for example, are provided on the nose cone 212 and the shoulder 213 to approximate the location of the proximal and distal edges 34, 36, respectively, of the stmt 10.
Alternatively, as shown in FIG. 6B, the outer sheath 220 may include one or more protrusions 227 for assisting in positioning the stmt 10 across the channel 262 (not shown in FIG. 6B). For example, the protrusion 227 may be a substantially rounded annulus molded directly onto the outer sheath 220 at a predetermined location with respect to the stem 10, e.g., at a midpoint thereof. The protrusion 227 may allow a user to detect when the outer sheath 220, and consequently the stent 10, are properly positioned across the channel 262, for example, based upon the resistance of the protrusion 227 to advancement beyond the channel 262, which :may substantially reduce the risk of over-advancing the stmt 10 beyond the channel 262.
Once the stmt 10 is properly positioned, the outer sheath 220 is withdrawn proximally to expose the stent 10 across the channel 262 (FIG. 4F). The balloon 208 may then be inflated, thereby expanding the stmt 10 to its enlarged condition (FIG. 4G). The inflation of the balloon 208 may be performed in two steps, first by inflating the balloon 208 to a first pressure, thereby expanding the stmt 10 to an intermediate enlarged condition and unwrapping the balloon 208 substantially from the catheter body 202 (not shown), and then by inflating the balloon 208 to a second higher pressure to fully expand the stmt 10 to its final enlarged condition (FIG. 9G).
T:he balloon 208 may then be deflated (FIG. 4H), and then the stmt delivery device 200 may be withdrawn over the guide wire 110 (FIG. 4I), leaving the stmt 10 substantially permanently implanted across the channel 262. Preferably, the stmt 10 substantially engages the lumens 256, 258 of the vein 252 and artery 254, respectively, as well as the tissue 260 surrounding the channel 262 to provide a substantially unimpaired passage for blood flow between the artery 254 and the vein 252.
In one form, the space between the cells 12 and/or between the curvilinear elements 22, 24 remains substantially open, thereby permitting fluid to pass through the circumference 18 of the stmt 10 and to continue flowing along the vessel and not cross through the channel 262 into the other vessel. For example, when a coronary vein is used to bypass an adjacent occluded coronary artery, it may be desirable to continue to allow some blood flow along the coronary artery to perfuse the occluded region.
Alternatively, a nonporous membrane (not shown) may be attached about the circumference 18 of the stent 10 to direct all fluid from the source vessel through the channel into t:he other vessel.
In an alternative method, because of differences in the diameters of the vein 252 and the artery 254, it may desirable to have the final diameter of the enlarged stent vary along its length, as shown in FIGS. 3B and 4H. For 10 example, the stmt 10 may be selected such that the first or intermediate enlarged condition corresponds to the diameter of the artery 254 and the second enlarged condition corresponds to the diameter of the vein 252. The balloon 208 may have a diameter that varies along its length, e.g., the diameter may be larger on a proximal portion of the balloon 208 (not shown), to facilitate proper expansion of the st:ent 10. Alternatively, the balloon 208 may be used to expand the stent 10 to the first enlarged condition, using the method previously described, and then a second balloon may be advanced over the guide wire 110 to expand specific cells 12 or portions of the stmt 10 to the second enlarged condition, as will be appreciated by those skilled in the art.
l.n another alternative, a portion of the stmt 10 may be provided from a self-expanding material, e.g., heat treated Nitinol, and another portion may be provided from a malleable as previously described. For example, it may be desirable to have the proximal end 10b automatically expand when deployed to engage one vessel, while the distal end l0a may be' selectively deformed to engage an adjacent vessel.
Prefei:ably, where the stent 10 is used to maintain a channel between a vein and an adjacent artery, the proximal end lOb may be self-expanding, thereby allowing the stmt 10 to automatically expand to engage the wall of the vein. The proximal end lOb of the stmt 10 may automatically enlarge to continuously engage the wall of the vein, thereby accommodating subsequent venous expansion which may occur over time as the vein is subjected to arterial pressure.
The distal end l0a may be plastically deformed, for example, 5 using a balloon catheter, to a desired enlarged condition, as described previously.
In another embodiment, particularly with regard to using the prosthesis 10 between two vessels to form an anastomosis therebetween, it may be desirable to form the 10 prosthesis 10 and the resulting connection in more ovular shape than is desired during simple intraluminal placement where the prosthesis 10 may be generally circular.
Elliptical connections in this particular application may promote a better physiologic response to the 15 implant, by lessening turbulence in the blood flow and imitating a more natural vessel condition.
Turning to FIGS. 7A-7C, an alternative embodiment of a stmt delivery device 300 is shown that provides continued blood perfusion during stmt delivery in accordance with 20 another aspect of the present invention. Most of the elements of this device are similar to the embodiment shown in FIG. 6A, with like elements having reference numbers increased by 100.
In particular, the stmt delivery device 300 includes a 25 catheter body 302, a nose cone 312, and an outer sheath 320.
The outer sheath 320 includes one or more perfusion holes 350 that extend from its outer wall to a lumen 326 for receiving the catheter body 302 therethrough, or to a separate lumen (not shown). The nose cone 312 also includes one or more perfusion holes 352, 354 proximal and distal to the widened portion 314, with a perfusion lumen 356 (shown in phantom in FIG. 7B) extending between them.
for example, as shown in FIG. 7C, the stent delivery device 300 may be positioned across a channel 262 between a vein 252 and an artery 254, for example during the stmt delivery method described above. The outer sheath 320 may substantially occlude the artery 254, such that without the perfusion holes 350, blood flow along the artery 254 would be substantially impaired. Because of the perfusion holes 350, 352, 354, however, blood may continue to travel along the artery 254, for example, first by entering the lumen 326 of the outer sheath 320 through the perfusion holes 350.
The blood may then enter the proximal or inlet perfusion holes 352 in the nose cone 312, pass through the perfusion lumen: 356, and then reenter the artery 254 through the distal_ or outlet perfusion holes 354 to continue downstream.
While the invention is susceptible to various modifications, and alternative forms, specific examples thereof have been shown in the drawings and are herein described in detail. It should be understood, however, that the invention is not to be limited to the particular forms or methods disclosed, but to the contrary, the invention is to cover all modifications, equivalents and alternatives falling within the spirit and scope of the appended claims.
Claims (56)
1. A prosthesis for implantation within a body passage, comprising:
a plurality of expandable segments defining a circumference and a longitudinal axis, each segment including an alternating pattern of curvilinear elements extending about the circumference, the alternating pattern including a first set of curvilinear elements having a first resistance to expansion and a second set of curvilinear elements having a second resistance to expansion substantially higher than the first resistance to expansion;
and a connector extending between adjacent segments.
a plurality of expandable segments defining a circumference and a longitudinal axis, each segment including an alternating pattern of curvilinear elements extending about the circumference, the alternating pattern including a first set of curvilinear elements having a first resistance to expansion and a second set of curvilinear elements having a second resistance to expansion substantially higher than the first resistance to expansion;
and a connector extending between adjacent segments.
2. The prosthesis of claim 1, wherein each segment is expandable between a contracted condition, a first expanded condition, and a second expanded condition, the first expanded condition being achieved when a radial force exceeding the first resistance to expansion is applied to the segment, the second expanded condition being achieved when a radial force exceeding the second resistance to expansion is applied to the segment.
3. The prosthesis of claim 1, wherein the first and second. sets of curvilinear elements comprise substantially "U" shaped elements having first and second longitudinal lengths, respectively, and wherein the second longitudinal length is substantially less than the first longitudinal length.
4. The prosthesis of claim 3, wherein the substantially "U" shaped elements of the first and second sets of curvilinear elements are connected to one another to define a substantially sinusoidal pattern extending circumferentially along the segments, the sinusoidal pattern having an alternating amplitude defined by the first and second. longitudinal lengths.
5. The prosthesis of claim 1, wherein the connector further comprises a pair of connectors located opposite one another on the circumference for facilitating articulation of the adjacent segments substantially transverse to the longitudinal axis.
6. The prosthesis of claim 1, wherein the connector includes a curve extending at least partially circumferentially along the circumference defined by the plurality of segments.
7. The prosthesis of claim 6, wherein the curve of the connector defines a sinusoidal shape adapted to extend and compress axially substantially evenly when the adjacent segments are subjected to a predetermined bending force.
8. An expandable stent, comprising a continuous tubular member plastically deformable between contracted and enlarged conditions and including a plurality of cylindrical segments, and a plurality of connectors extending between adjacent cylindrical segments, each cylindrical segment having an alternating circumferential pattern of curvilinear elements having different resistances to radial expansion.
9. The expandable stent of claim 8, wherein the circumferential pattern comprises first and second sets of "U" shaped elements having first and second longitudinal lengths, respectively, and wherein the second longitudinal length is substantially less than the first longitudinal length.
10. The expandable stent of claim 9, wherein the substantially "U" shaped elements are connected to one another to define a substantially sinusoidal pattern extending circumferentially along each cylindrical segment, the sinusoidal pattern having an amplitude alternatively defined by the first and second longitudinal lengths.
11. The expandable stent of claim 8, wherein the connector further comprises a pair of connectors located opposite one another on the circumference for facilitating articulation of the adjacent cylindrical segments about the longitudinal axis.
12. The expandable stent of claim 8, wherein the connector includes a curve extending at least partially circumferentially along the circumference defined by the plurality of cylindrical segments.
13. The expandable stent of claim 12, wherein the curve of the connector defines a sinusoidal shape adapted to extend and compress axially substantially evenly when the adjacent cylindrical segments are subjected to a predetermined bending force about the longitudinal axis.
14. An expandable stent, comprising:
a plurality of cylindrical segments plastically deformable between contracted and enlarged conditions and defining a circumference and a longitudinal axis; and a connector extending between adjacent segments, each connector having a substantially sinusoidal shape extending about an axis substantially parallel to the longitudinal axis.
a plurality of cylindrical segments plastically deformable between contracted and enlarged conditions and defining a circumference and a longitudinal axis; and a connector extending between adjacent segments, each connector having a substantially sinusoidal shape extending about an axis substantially parallel to the longitudinal axis.
15. The expandable stent of claim 14, wherein the connector further comprises a pair of connectors located opposite one another on the circumference of the cylindrical segments, and wherein the sinusoidal shape allows opposing pairs of connectors to extend and compress axially, respectively, substantially evenly when the adjacent cylindrical segments are subjected to a predetermined bending force about the longitudinal axis.
16. The expandable stent of claim 14, wherein the cylindrical segments comprise a circumferential pattern including first and second sets of "U" shaped elements having first and second longitudinal lengths, respectively, and wherein the second longitudinal length is substantially less than the first longitudinal length.
17. The expandable stent of claim 14, wherein the cylindrical segments include a zigzag pattern extending circumferentially about each cylindrical segment, the zigzag pattern having an amplitude alternating between by the first and second longitudinal lengths.
18. The expandable stent of claim 14, wherein each segment is expandable between a contracted condition, a first expanded condition, and a second expanded condition.
19. The expandable stent of claim 18, wherein the, cylindrical segments comprise a circumferential pattern of alternating first and second sets of curvilinear elements having alternating first and second resistances to expansion, and wherein the first expanded condition is achieved when a radial force exceeding the first resistance to expansion is applied to the cylindrical segments, and the second expanded condition is achieved when a radial force exceeding the second resistance to expansion is applied to the cylindrical segments.
20. A device for delivering an expandable stent to a site within a patient's body, comprising:
an elongate member having proximal and distal ends;
a nose cone on the distal end, the nose cone having a widened portion and a tapered distal tip to facilitate insertion along a body passage; and an expandable member on the elongate member proximate to the nose cone for receiving an expandable stent thereon.
an elongate member having proximal and distal ends;
a nose cone on the distal end, the nose cone having a widened portion and a tapered distal tip to facilitate insertion along a body passage; and an expandable member on the elongate member proximate to the nose cone for receiving an expandable stent thereon.
21. The device of claim 20, further comprising an outer sheath slidable over the elongate member, the outer sheath including a lumen for receiving the elongate member therethrough.
22. The device of claim 21, wherein the outer sheath includes a distal end having a diameter substantially similar to the widened portion of the nose cone.
23. The device of claim 21, wherein the outer sheath includes one or more perfusion holes extending between an outer surface of the outer sheath and the lumen.
24. The device of claim 21, wherein the outer sheath includes a tactile indicator on its outer surface proximate a distal end of the outer sheath.
25. The device of claim 29, wherein the tactile indicator comprises a protrusion on an outer surface of the outer sheath, the protrusion having a predetermined relationship with the expandable member when the elongate member is received within the outer sheath.
26. The device of claim 21, wherein the outer sheath includes an expandable dilation member proximate a distal end of the sheath for dilating a portion of a body passage.
27. The device of claim 20, wherein the nose cone includes perfusion holes proximal and distal of the widened portion.
28. The device of claim 20, further comprising an externally detectable marker on the elongate member at a predetermined location with respect to the expandable member.
29. The device of claim 20, further comprising a shoulder on the elongate member proximate the expandable member, the shoulder having a blunt distal edge for engaging a proximal end of an expandable stent received on the expandable member to prevent substantial proximal movement of the expandable stent.
30. The device of claim 29, wherein the shoulder includes a substantially tapered proximal edge to facilitate withdrawal of the elongate member from a body passage.
31. A method of implanting a stent within a curved region of a body passage, the stent including a plurality of cylindrical segments and a plurality of connectors extending between adjacent segments, each segment including a circumferential pattern of alternating curvilinear elements, the method comprising the steps of:
placing the stent in a contracted condition on a distal end of a stent delivery device;
advancing the distal end of the stent delivery device along the body passage;
positioning the stent within the curved region;
expanding the stent to an intermediate enlarged condition to substantially eliminate localized radial forces;
expanding the stent further to a final enlarged condition, the circumferential pattern of alternating curvilinear elements expanding substantially evenly about a circumference of the stent to scaffold the curved region;
and withdrawing the stent delivery catheter from the body passage.
placing the stent in a contracted condition on a distal end of a stent delivery device;
advancing the distal end of the stent delivery device along the body passage;
positioning the stent within the curved region;
expanding the stent to an intermediate enlarged condition to substantially eliminate localized radial forces;
expanding the stent further to a final enlarged condition, the circumferential pattern of alternating curvilinear elements expanding substantially evenly about a circumference of the stent to scaffold the curved region;
and withdrawing the stent delivery catheter from the body passage.
32. The method of claim 31, wherein the curved region comprises a channel extending between adjacent blood vessels.
33. The method of claim 32, wherein the adjacent blood vessels comprise a coronary vein and a coronary artery.
34. The method of claim 31, wherein the stent delivery catheter includes a balloon thereon onto which the stent is placed, and wherein the balloon is inflated to expand the stent to the intermediate and final enlarged conditions.
35. The method of claim 34, wherein the balloon is wrapped around the catheter body prior to placing the stent thereon, and wherein the balloon automatically unwraps substantially as it is inflated to expand the stent to the intermediate enlarged condition.
36. The method of claim 31, wherein the connectors include a curve extending partially transversely along the circumference of the stent, and wherein connectors disposed opposite one another about the circumference are axially extended and compressed, respectively, substantially evenly as the stent bends during the step of expanding the stent to the final enlarged condition to scaffold the curved region.
37. A method of implanting a stent across a channel connecting two adjacent blood vessels within a patient's body, the stent including a plurality of cylindrical segments and a plurality of connectors extending between adjacent segments, each segment including a circumferential pattern of alternating curvilinear elements, whereby the stent is plastically deformable between a contracted condition, an intermediate enlarged condition and a final enlarged condition, the method comprising the steps of:
placing the stent in the contracted condition over an expandable member on a distal end of a stent delivery device;
advancing the distal end of the stent delivery device within a first blood vessel until the stent is positioned across the channel;
expanding the stent to the intermediate enlarged condition to substantially eliminate localized radial forces created by the expandable member;
expanding at least a portion of the stent to the final enlarged condition, the portion of the stent expanding substantially evenly about its circumference; and withdrawing the stent delivery catheter.
placing the stent in the contracted condition over an expandable member on a distal end of a stent delivery device;
advancing the distal end of the stent delivery device within a first blood vessel until the stent is positioned across the channel;
expanding the stent to the intermediate enlarged condition to substantially eliminate localized radial forces created by the expandable member;
expanding at least a portion of the stent to the final enlarged condition, the portion of the stent expanding substantially evenly about its circumference; and withdrawing the stent delivery catheter.
38. The method of claim 37, comprising the additional step of placing a guide wire across the channel from one of the two adjacent blood vessels, over which the stent delivery device is advanced and withdrawn.
39. The method of claim 37, wherein the adjacent blood vessels comprise a coronary vein and a coronary artery.
40. The method of claim 37, wherein the circumferential pattern includes a first set of curvilinear elements having a first resistance to expansion, and a second set of curvilinear elements having a second resistance to expansion substantially higher than the first resistance to expansion, and wherein the intermediate enlarged condition is achieved by overcoming the first resistance to expansion, and wherein the final enlarged condition is achieved by overcoming the second resistance to expansion.
41. The method of claim 37, wherein the stent delivery device includes a marker in a predetermined relationship with the stent, and wherein the marker is observed while the stent is positioned across the channel.
42. The method of claim 37, comprising the additional step of creating the channel between the adjacent blood vessels.
43. The method of claim 42, wherein the channel is created by cutting or removing tissue between the adjacent blood vessels.
44. The method of claim 37, comprising the additional step of dilating the channel to a predetermined size.
45. The method of claim 44, wherein the stent delivery device comprises a nose cone on its distal end, and wherein the nose cone dilates the channel when the distal end of the stent delivery device is advanced through the channel.
46. The method of claim 44, wherein an expandable dilation member is advanced into the channel and expanded to dilate the channel to the predetermined size.
47. The method of claim 44, wherein the stent delivery device includes an outer sheath, and wherein an expandable member on the outer sheath is expanded to dilate the channel to the predetermined size.
48. A method of delivering an expandable stent to a selected delivery site within a patient's body using a stent delivery device that includes an elongate member having an expandable member and a nose cone on its distal end, and an outer sheath for slidably receiving the elongate member therein, the method comprising the steps of:
placing a stent in a contracted condition on the expandable member;
inserting the elongate member into the outer sheath to cover the stent, the outer sheath engaging the nose cone to provide a substantially smooth transition therebetween;
advancing the distal end of the elongate member along a body passage within the patient's body;
positioning the stent at the selected delivery site;
withdrawing the outer sheath proximally to expose the stent at the selected delivery site;
expanding the stent to an enlarged condition with the expandable member; and withdrawing the elongate member from the patient's body.
placing a stent in a contracted condition on the expandable member;
inserting the elongate member into the outer sheath to cover the stent, the outer sheath engaging the nose cone to provide a substantially smooth transition therebetween;
advancing the distal end of the elongate member along a body passage within the patient's body;
positioning the stent at the selected delivery site;
withdrawing the outer sheath proximally to expose the stent at the selected delivery site;
expanding the stent to an enlarged condition with the expandable member; and withdrawing the elongate member from the patient's body.
49. The method of claim 48, wherein the elongate member includes a shoulder proximate the expandable member for preventing substantial proximal movement of the stent received thereon.
50. The method of claim 48, wherein the body passage comprises a vein, and wherein the selected delivery site comprises a channel connecting the vein to an adjacent artery.
51. The method of claim 50, wherein the nose cone at least partially dilates the channel when the distal end of the catheter body is advanced therethrough.
52. The method of claim 50, wherein the outer sheath includes perfusion holes therethrough to allow continued flow of blood along the artery when the stent is positioned at the selected delivery site.
53. The method of claim 50, wherein the nose cone includes perfusion holes therethrough to allow continued flow of blood along the artery when the stent is positioned at the selected delivery site.
54. The method of claim 48, wherein the stent delivery device includes an externally observable marker, and wherein the marker is observed when the stent is positioned at the selected delivery site.
55. The method of claim 48, further comprising the step of dilating the selected delivery site with an expandable member on the outer sheath.
56. The method of claim 48, wherein the outer sheath includes an outer protrusion, and wherein the protrusion produces a tactile indication when the stent is positioned at the selected delivery site.
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US09/089,032 | 1998-06-02 | ||
US09/089,032 US6330884B1 (en) | 1997-11-14 | 1998-06-02 | Deformable scaffolding multicellular stent |
PCT/US1999/010645 WO1999062430A1 (en) | 1998-06-02 | 1999-05-13 | Deformable scaffolding multicellular stent |
Publications (1)
Publication Number | Publication Date |
---|---|
CA2333764A1 true CA2333764A1 (en) | 1999-12-09 |
Family
ID=22215138
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
CA002333764A Abandoned CA2333764A1 (en) | 1998-06-02 | 1999-05-13 | Deformable scaffolding multicellular stent |
Country Status (6)
Country | Link |
---|---|
US (3) | US6330884B1 (en) |
EP (1) | EP1082070B1 (en) |
JP (1) | JP4498604B2 (en) |
AU (1) | AU751389B2 (en) |
CA (1) | CA2333764A1 (en) |
WO (1) | WO1999062430A1 (en) |
Families Citing this family (253)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US7204848B1 (en) | 1995-03-01 | 2007-04-17 | Boston Scientific Scimed, Inc. | Longitudinally flexible expandable stent |
US6602281B1 (en) * | 1995-06-05 | 2003-08-05 | Avantec Vascular Corporation | Radially expansible vessel scaffold having beams and expansion joints |
US7686846B2 (en) | 1996-06-06 | 2010-03-30 | Devax, Inc. | Bifurcation stent and method of positioning in a body lumen |
US8728143B2 (en) | 1996-06-06 | 2014-05-20 | Biosensors International Group, Ltd. | Endoprosthesis deployment system for treating vascular bifurcations |
US7238197B2 (en) | 2000-05-30 | 2007-07-03 | Devax, Inc. | Endoprosthesis deployment system for treating vascular bifurcations |
US6666883B1 (en) | 1996-06-06 | 2003-12-23 | Jacques Seguin | Endoprosthesis for vascular bifurcation |
US6325826B1 (en) * | 1998-01-14 | 2001-12-04 | Advanced Stent Technologies, Inc. | Extendible stent apparatus |
US6231546B1 (en) | 1998-01-13 | 2001-05-15 | Lumend, Inc. | Methods and apparatus for crossing total occlusions in blood vessels |
US6261319B1 (en) * | 1998-07-08 | 2001-07-17 | Scimed Life Systems, Inc. | Stent |
US7004962B2 (en) * | 1998-07-27 | 2006-02-28 | Schneider (Usa), Inc. | Neuroaneurysm occlusion and delivery device and method of using same |
US6406488B1 (en) * | 1998-08-27 | 2002-06-18 | Heartstent Corporation | Healing transmyocardial implant |
US6254564B1 (en) * | 1998-09-10 | 2001-07-03 | Percardia, Inc. | Left ventricular conduit with blood vessel graft |
WO2000015147A1 (en) * | 1998-09-10 | 2000-03-23 | Percardia, Inc. | Transmycardial shunt and its attachment mechanism, for left ventricular revascularization |
US6641610B2 (en) * | 1998-09-10 | 2003-11-04 | Percardia, Inc. | Valve designs for left ventricular conduits |
EP1112043B1 (en) * | 1998-09-10 | 2006-04-05 | Percardia, Inc. | Tmr shunt |
US6196230B1 (en) * | 1998-09-10 | 2001-03-06 | Percardia, Inc. | Stent delivery system and method of use |
US6290728B1 (en) | 1998-09-10 | 2001-09-18 | Percardia, Inc. | Designs for left ventricular conduit |
US6261304B1 (en) | 1998-09-10 | 2001-07-17 | Percardia, Inc. | Delivery methods for left ventricular conduit |
DE69922976T2 (en) | 1998-09-30 | 2005-12-08 | Bard Peripheral Vascular, Inc., Tempe | EMBODIMENT FOR IMPLANTABLE STENTS |
US6355057B1 (en) † | 1999-01-14 | 2002-03-12 | Medtronic, Inc. | Staggered endoluminal stent |
US6302892B1 (en) | 1999-08-04 | 2001-10-16 | Percardia, Inc. | Blood flow conduit delivery system and method of use |
US6253768B1 (en) | 1999-08-04 | 2001-07-03 | Percardia, Inc. | Vascular graft bypass |
US6638237B1 (en) | 1999-08-04 | 2003-10-28 | Percardia, Inc. | Left ventricular conduits and methods for delivery |
US7713279B2 (en) | 2000-12-20 | 2010-05-11 | Fox Hollow Technologies, Inc. | Method and devices for cutting tissue |
US6299622B1 (en) | 1999-08-19 | 2001-10-09 | Fox Hollow Technologies, Inc. | Atherectomy catheter with aligned imager |
US7887556B2 (en) * | 2000-12-20 | 2011-02-15 | Fox Hollow Technologies, Inc. | Debulking catheters and methods |
US7708749B2 (en) | 2000-12-20 | 2010-05-04 | Fox Hollow Technologies, Inc. | Debulking catheters and methods |
US8328829B2 (en) | 1999-08-19 | 2012-12-11 | Covidien Lp | High capacity debulking catheter with razor edge cutting window |
US6638233B2 (en) | 1999-08-19 | 2003-10-28 | Fox Hollow Technologies, Inc. | Apparatus and methods for material capture and removal |
US6605053B1 (en) | 1999-09-10 | 2003-08-12 | Percardia, Inc. | Conduit designs and related methods for optimal flow control |
US20070265563A1 (en) * | 2006-05-11 | 2007-11-15 | Heuser Richard R | Device for treating chronic total occlusion |
US6423090B1 (en) * | 2000-02-11 | 2002-07-23 | Advanced Cardiovascular Systems, Inc. | Stent pattern with staged expansion |
US9522217B2 (en) | 2000-03-15 | 2016-12-20 | Orbusneich Medical, Inc. | Medical device with coating for capturing genetically-altered cells and methods for using same |
US8088060B2 (en) | 2000-03-15 | 2012-01-03 | Orbusneich Medical, Inc. | Progenitor endothelial cell capturing with a drug eluting implantable medical device |
US8460367B2 (en) | 2000-03-15 | 2013-06-11 | Orbusneich Medical, Inc. | Progenitor endothelial cell capturing with a drug eluting implantable medical device |
JP3782297B2 (en) * | 2000-03-28 | 2006-06-07 | 株式会社東芝 | Solid-state imaging device and manufacturing method thereof |
US6964676B1 (en) | 2000-04-14 | 2005-11-15 | Scimed Life Systems, Inc. | Stent securement system |
US7722663B1 (en) | 2000-04-24 | 2010-05-25 | Scimed Life Systems, Inc. | Anatomically correct endoluminal prostheses |
DE60115235T2 (en) * | 2000-04-28 | 2006-08-10 | Children's Medical Center Corp., Boston | FABRIC BUILT STENT |
US6616689B1 (en) * | 2000-05-03 | 2003-09-09 | Advanced Cardiovascular Systems, Inc. | Intravascular stent |
US6854467B2 (en) * | 2000-05-04 | 2005-02-15 | Percardia, Inc. | Methods and devices for delivering a ventricular stent |
JP4754714B2 (en) * | 2000-06-01 | 2011-08-24 | テルモ株式会社 | Intraluminal indwelling |
US20020032478A1 (en) * | 2000-08-07 | 2002-03-14 | Percardia, Inc. | Myocardial stents and related methods of providing direct blood flow from a heart chamber to a coronary vessel |
ES2436668T3 (en) | 2000-12-20 | 2014-01-03 | Covidien Lp | Catheter to remove atheromatous or thrombotic occlusive material |
US7927784B2 (en) | 2000-12-20 | 2011-04-19 | Ev3 | Vascular lumen debulking catheters and methods |
US7699790B2 (en) | 2000-12-20 | 2010-04-20 | Ev3, Inc. | Debulking catheters and methods |
US6976990B2 (en) * | 2001-01-25 | 2005-12-20 | Percardia, Inc. | Intravascular ventriculocoronary bypass via a septal passageway |
US6740114B2 (en) * | 2001-03-01 | 2004-05-25 | Cordis Corporation | Flexible stent |
US6790227B2 (en) * | 2001-03-01 | 2004-09-14 | Cordis Corporation | Flexible stent |
US6939373B2 (en) | 2003-08-20 | 2005-09-06 | Advanced Cardiovascular Systems, Inc. | Intravascular stent |
US6629994B2 (en) | 2001-06-11 | 2003-10-07 | Advanced Cardiovascular Systems, Inc. | Intravascular stent |
US20030036698A1 (en) * | 2001-08-16 | 2003-02-20 | Robert Kohler | Interventional diagnostic catheter and a method for using a catheter to access artificial cardiac shunts |
US7842083B2 (en) | 2001-08-20 | 2010-11-30 | Innovational Holdings, Llc. | Expandable medical device with improved spatial distribution |
US20040111108A1 (en) | 2001-11-09 | 2004-06-10 | Farnan Robert C. | Balloon catheter with non-deployable stent |
US6949118B2 (en) * | 2002-01-16 | 2005-09-27 | Percardia, Inc. | Encased implant and methods |
US7008397B2 (en) * | 2002-02-13 | 2006-03-07 | Percardia, Inc. | Cardiac implant and methods |
US20030220661A1 (en) * | 2002-05-21 | 2003-11-27 | Heartstent Corporation | Transmyocardial implant delivery system |
US6656220B1 (en) | 2002-06-17 | 2003-12-02 | Advanced Cardiovascular Systems, Inc. | Intravascular stent |
US6878162B2 (en) | 2002-08-30 | 2005-04-12 | Edwards Lifesciences Ag | Helical stent having improved flexibility and expandability |
US9561123B2 (en) | 2002-08-30 | 2017-02-07 | C.R. Bard, Inc. | Highly flexible stent and method of manufacture |
US6786922B2 (en) * | 2002-10-08 | 2004-09-07 | Cook Incorporated | Stent with ring architecture and axially displaced connector segments |
US20040093056A1 (en) | 2002-10-26 | 2004-05-13 | Johnson Lianw M. | Medical appliance delivery apparatus and method of use |
US7875068B2 (en) | 2002-11-05 | 2011-01-25 | Merit Medical Systems, Inc. | Removable biliary stent |
US7959671B2 (en) | 2002-11-05 | 2011-06-14 | Merit Medical Systems, Inc. | Differential covering and coating methods |
US7637942B2 (en) | 2002-11-05 | 2009-12-29 | Merit Medical Systems, Inc. | Coated stent with geometry determinated functionality and method of making the same |
FR2846520B1 (en) * | 2002-11-06 | 2006-09-29 | Roquette Freres | USE OF MALTODEXTRINS BRANCHED AS BLEACHES OF GRANULATION |
AU2002356575B2 (en) | 2002-11-08 | 2009-07-16 | Jean-Claude Laborde | Endoprosthesis for vascular bifurcation |
US6923829B2 (en) * | 2002-11-25 | 2005-08-02 | Advanced Bio Prosthetic Surfaces, Ltd. | Implantable expandable medical devices having regions of differential mechanical properties and methods of making same |
US8105373B2 (en) * | 2002-12-16 | 2012-01-31 | Boston Scientific Scimed, Inc. | Flexible stent with improved axial strength |
US6928669B2 (en) * | 2003-01-10 | 2005-08-16 | Tyler Pipe Company | Closet carrier system and method of assembly |
US7166088B2 (en) * | 2003-01-27 | 2007-01-23 | Heuser Richard R | Catheter introducer system |
US7637934B2 (en) | 2003-03-31 | 2009-12-29 | Merit Medical Systems, Inc. | Medical appliance optical delivery and deployment apparatus and method |
US8246640B2 (en) | 2003-04-22 | 2012-08-21 | Tyco Healthcare Group Lp | Methods and devices for cutting tissue at a vascular location |
US20040215220A1 (en) * | 2003-04-24 | 2004-10-28 | Dolan Mark J. | Anastomotic stent, apparatus and methods of use thereof |
US7604660B2 (en) | 2003-05-01 | 2009-10-20 | Merit Medical Systems, Inc. | Bifurcated medical appliance delivery apparatus and method |
US7131993B2 (en) * | 2003-06-25 | 2006-11-07 | Boston Scientific Scimed, Inc. | Varying circumferential spanned connectors in a stent |
US7402141B2 (en) * | 2003-08-27 | 2008-07-22 | Heuser Richard R | Catheter guidewire system using concentric wires |
US7806918B2 (en) * | 2003-09-30 | 2010-10-05 | Merit Medical Systems, Inc. | Removable stent |
US20050131530A1 (en) * | 2003-12-15 | 2005-06-16 | Darack Ed E. | Endoluminal stent |
US20050154439A1 (en) * | 2004-01-08 | 2005-07-14 | Gunderson Richard C. | Medical device delivery systems |
DE102004012981B4 (en) * | 2004-03-16 | 2009-01-02 | Alveolus Inc. | stent |
US20050278013A1 (en) * | 2004-05-26 | 2005-12-15 | Matthew Rust | Method for endovascular bypass stent graft delivery |
US8545418B2 (en) | 2004-08-25 | 2013-10-01 | Richard R. Heuser | Systems and methods for ablation of occlusions within blood vessels |
US20090012429A1 (en) * | 2004-08-25 | 2009-01-08 | Heuser Richard R | Catheter guidewire system using concentric wires |
US7780721B2 (en) * | 2004-09-01 | 2010-08-24 | C. R. Bard, Inc. | Stent and method for manufacturing the stent |
US20060064155A1 (en) * | 2004-09-01 | 2006-03-23 | Pst, Llc | Stent and method for manufacturing the stent |
GB0419954D0 (en) | 2004-09-08 | 2004-10-13 | Advotek Medical Devices Ltd | System for directing therapy |
WO2006035669A1 (en) * | 2004-09-28 | 2006-04-06 | Nipro Corporation | Soft stent excellent in vascular follow-up and dilation nature |
US7887579B2 (en) | 2004-09-29 | 2011-02-15 | Merit Medical Systems, Inc. | Active stent |
DE102005003632A1 (en) | 2005-01-20 | 2006-08-17 | Fraunhofer-Gesellschaft zur Förderung der angewandten Forschung e.V. | Catheter for the transvascular implantation of heart valve prostheses |
JP4892193B2 (en) * | 2005-03-01 | 2012-03-07 | Dowaホールディングス株式会社 | Phosphor mixture and light emitting device |
US7794413B2 (en) | 2005-04-19 | 2010-09-14 | Ev3, Inc. | Libraries and data structures of materials removed by debulking catheters |
US20060263145A1 (en) * | 2005-04-20 | 2006-11-23 | Dharmendra Pal | Internal cannulated joint for medical delivery systems |
AU2006236229B2 (en) * | 2005-04-20 | 2011-03-17 | Cook Medical Technologies Llc | Joint for medical device delivery system |
EP1871295B1 (en) * | 2005-04-20 | 2016-05-11 | Cook Medical Technologies LLC | Medical delivery apparatus having tapered components |
EP1871453B1 (en) * | 2005-04-20 | 2010-02-24 | Cook Incorporated | Melt-bonded joint for medical devices |
US8652193B2 (en) * | 2005-05-09 | 2014-02-18 | Angiomed Gmbh & Co. Medizintechnik Kg | Implant delivery device |
US10076641B2 (en) | 2005-05-11 | 2018-09-18 | The Spectranetics Corporation | Methods and systems for delivering substances into luminal walls |
EP1885288B1 (en) * | 2005-05-13 | 2015-03-18 | Merit Medical Systems, Inc. | Drainage stent and associated method |
US7731654B2 (en) | 2005-05-13 | 2010-06-08 | Merit Medical Systems, Inc. | Delivery device with viewing window and associated method |
FR2887432A1 (en) * | 2005-06-27 | 2006-12-29 | Younes Boudjemline | MINI-INVASIVE SYSTEM FOR THE COMMUNICATION OF TWO BODY CONDUITS |
WO2007033052A2 (en) | 2005-09-12 | 2007-03-22 | Bridgepoint Medical, Inc. | Endovascular devices and methods for exploiting intramural space |
US11020141B2 (en) | 2005-09-12 | 2021-06-01 | Bridgepoint Medical, Inc. | Endovascular devices and methods |
US8025655B2 (en) | 2005-09-12 | 2011-09-27 | Bridgepoint Medical, Inc. | Endovascular devices and methods |
US7918870B2 (en) | 2005-09-12 | 2011-04-05 | Bridgepoint Medical, Inc. | Endovascular devices and methods |
US8083727B2 (en) | 2005-09-12 | 2011-12-27 | Bridgepoint Medical, Inc. | Endovascular devices and methods for exploiting intramural space |
US8062321B2 (en) * | 2006-01-25 | 2011-11-22 | Pq Bypass, Inc. | Catheter system for connecting adjacent blood vessels |
US20070203572A1 (en) * | 2006-01-25 | 2007-08-30 | Heuser Richard R | Catheter system with stent apparatus for connecting adjacent blood vessels |
US20070203515A1 (en) * | 2006-01-25 | 2007-08-30 | Heuser Richard R | Catheter system for connecting adjacent blood vessels |
EP3127508A1 (en) | 2006-02-14 | 2017-02-08 | Angiomed GmbH & Co. Medizintechnik KG | Highly flexible stent |
US7989207B2 (en) * | 2006-02-17 | 2011-08-02 | Tyco Healthcare Group Lp | Testing lumenectomy samples for markers of non-vascular diseases |
GB0607761D0 (en) | 2006-04-20 | 2006-05-31 | Site Specific Therapies Ltd | Variable density stent |
US20130190676A1 (en) | 2006-04-20 | 2013-07-25 | Limflow Gmbh | Devices and methods for fluid flow through body passages |
US20070276419A1 (en) | 2006-05-26 | 2007-11-29 | Fox Hollow Technologies, Inc. | Methods and devices for rotating an active element and an energy emitter on a catheter |
US8029558B2 (en) * | 2006-07-07 | 2011-10-04 | Abbott Cardiovascular Systems, Inc. | Stent and catheter assembly and method for treating bifurcations |
WO2008013803A2 (en) * | 2006-07-24 | 2008-01-31 | Massachusetts Institute Of Technology | Endovascular devices with axial perturbations |
US8211163B2 (en) * | 2006-09-13 | 2012-07-03 | Boston Scientific Scimed, Inc. | Hybrid symmetrical stent designs |
US8778009B2 (en) | 2006-10-06 | 2014-07-15 | Abbott Cardiovascular Systems Inc. | Intravascular stent |
US8858584B2 (en) * | 2006-11-07 | 2014-10-14 | Cook Medical Technologies Llc | Emergency transection device |
US10888354B2 (en) | 2006-11-21 | 2021-01-12 | Bridgepoint Medical, Inc. | Endovascular devices and methods for exploiting intramural space |
US11298511B2 (en) | 2006-11-21 | 2022-04-12 | Bridgepoint Medical, Inc. | Endovascular devices and methods for exploiting intramural space |
US9060802B2 (en) | 2006-11-21 | 2015-06-23 | Bridgepoint Medical, Inc. | Endovascular devices and methods for exploiting intramural space |
US20080177249A1 (en) * | 2007-01-22 | 2008-07-24 | Heuser Richard R | Catheter introducer system |
US8333799B2 (en) | 2007-02-12 | 2012-12-18 | C. R. Bard, Inc. | Highly flexible stent and method of manufacture |
US8328865B2 (en) * | 2007-02-12 | 2012-12-11 | C. R. Bard, Inc. | Highly flexible stent and method of manufacture |
US8512392B2 (en) * | 2007-03-09 | 2013-08-20 | Boston Scientific Scimed, Inc. | Stent design with struts of various angles and stiffness |
US20080234813A1 (en) * | 2007-03-20 | 2008-09-25 | Heuser Richard R | Percutaneous Interventional Cardiology System for Treating Valvular Disease |
US8257382B2 (en) * | 2007-03-29 | 2012-09-04 | Boston Scientific Limited | Lumen reentry devices and methods |
US7896915B2 (en) | 2007-04-13 | 2011-03-01 | Jenavalve Technology, Inc. | Medical device for treating a heart valve insufficiency |
US20080269745A1 (en) | 2007-04-24 | 2008-10-30 | Osteolign, Inc. | Thermo-chemically activated intramedullary bone stent |
JP5398971B2 (en) * | 2007-10-01 | 2014-01-29 | オリンパスメディカルシステムズ株式会社 | Stent placement device |
EP3659664A1 (en) | 2007-10-22 | 2020-06-03 | Bridgepoint Medical, Inc. | Devices for crossing chronic total occlusions |
WO2009076515A1 (en) | 2007-12-11 | 2009-06-18 | Cornell University | Method and apparatus for sealing an opening in the side wall of a body lumen |
US8968382B2 (en) | 2007-12-11 | 2015-03-03 | Cornell University | Method and apparatus for restricting flow through an opening in the side wall |
EP3251719B1 (en) | 2008-02-05 | 2020-10-21 | Bridgepoint Medical, Inc. | Crossing occlusions in blood vessels |
US8337425B2 (en) | 2008-02-05 | 2012-12-25 | Bridgepoint Medical, Inc. | Endovascular device with a tissue piercing distal probe and associated methods |
US8784440B2 (en) | 2008-02-25 | 2014-07-22 | Covidien Lp | Methods and devices for cutting tissue |
ES2903231T3 (en) | 2008-02-26 | 2022-03-31 | Jenavalve Tech Inc | Stent for positioning and anchoring a valve prosthesis at an implantation site in a patient's heart |
US9044318B2 (en) | 2008-02-26 | 2015-06-02 | Jenavalve Technology Gmbh | Stent for the positioning and anchoring of a valvular prosthesis |
US10456554B2 (en) * | 2008-04-17 | 2019-10-29 | W. L. Gore & Associates, Inc. | Device delivery catheter having a curved distal tip |
US8172863B2 (en) | 2008-04-28 | 2012-05-08 | Bridgepoint Medical, Inc. | Methods and apparatus for crossing occlusions in blood vessels |
DE202008009604U1 (en) * | 2008-07-17 | 2008-11-27 | Sahl, Harald, Dr. | Membrane implant for the treatment of cerebral artery aneurysms |
US20100022940A1 (en) * | 2008-07-25 | 2010-01-28 | Medtronic Vascular, Inc. | Percutaneously Introduceable Shunt Devices and Methods |
US20110190637A1 (en) * | 2008-08-18 | 2011-08-04 | Naviswiss Ag | Medical measuring system, method for surgical intervention as well as use of a medical measuring system |
US8597454B2 (en) | 2008-09-23 | 2013-12-03 | Cook Medical Technologies Llc | Catheter tip assembly |
AU2009303501B2 (en) | 2008-10-13 | 2013-11-21 | Covidien Lp | Devices and methods for manipulating a catheter shaft |
EP2389141B1 (en) | 2009-01-22 | 2018-12-26 | Cornell University | Apparatus for restricting flow through the wall of a lumen |
US20100191168A1 (en) | 2009-01-29 | 2010-07-29 | Trustees Of Tufts College | Endovascular cerebrospinal fluid shunt |
RU2509537C2 (en) | 2009-04-29 | 2014-03-20 | ТАЙКО ХЕЛСКЕА ГРУП эЛПи | Methods and devices for tissue cutting and cleansing |
CN102458276B (en) | 2009-05-14 | 2014-05-21 | 泰科保健集团有限合伙公司 | Easily cleaned atherectomy catheters and methods of use |
US8784467B2 (en) | 2009-05-15 | 2014-07-22 | Lemaitre Vascular, Inc. | Non-occlusive dilation devices |
WO2011008981A1 (en) * | 2009-07-15 | 2011-01-20 | Regents Of The University Of Minnesota | Implantable devices for treatment of sinusitis |
WO2011008987A2 (en) | 2009-07-15 | 2011-01-20 | Regents Of The University Of Minnesota | Treatment and placement device for sinusitis applications |
US20120265233A1 (en) | 2009-08-28 | 2012-10-18 | Lea Waisman | Inverted balloon neck on catheter |
US20110106099A1 (en) | 2009-10-29 | 2011-05-05 | Medtronic, Inc. | Lead extraction device |
CN104490454A (en) | 2009-12-02 | 2015-04-08 | 泰科保健集团有限合伙公司 | Methods And Devices For Cutting Tissue |
CA2783301C (en) | 2009-12-11 | 2015-02-24 | Tyco Healthcare Group Lp | Material removal device having improved material capture efficiency and methods of use |
US20110319976A1 (en) * | 2010-01-27 | 2011-12-29 | Sriram Iyer | Device and method for preventing stenosis at an anastomosis site |
EP2380604A1 (en) | 2010-04-19 | 2011-10-26 | InnoRa Gmbh | Improved coating formulations for scoring or cutting balloon catheters |
CN103002833B (en) | 2010-05-25 | 2016-05-11 | 耶拿阀门科技公司 | Artificial heart valve and comprise artificial heart valve and support through conduit carry interior prosthese |
US9192746B2 (en) | 2010-06-07 | 2015-11-24 | Cook Medical Technologies Llc | Reperfusion catheter system |
EP2579791B1 (en) | 2010-06-14 | 2014-04-23 | Covidien LP | Material removal device |
JP5864064B2 (en) | 2010-06-15 | 2016-02-17 | アベヌ メディカル インコーポレイテッドAvenu Medical,Inc. | System and method for making an arteriovenous (AV) fistula |
CA2804525C (en) | 2010-06-15 | 2018-09-04 | Caymus Medical, Inc. | Intravascular arterial to venous anastomosis and tissue welding catheter |
US9247942B2 (en) | 2010-06-29 | 2016-02-02 | Artventive Medical Group, Inc. | Reversible tubal contraceptive device |
WO2012002944A1 (en) | 2010-06-29 | 2012-01-05 | Artventive Medical Group, Inc. | Reducing flow through a tubular structure |
CA2807656A1 (en) | 2010-08-30 | 2012-03-08 | SinuSys Corporation | Devices and methods for dilating a paranasal sinus opening and for treating sinusitis |
US8632559B2 (en) | 2010-09-21 | 2014-01-21 | Angioscore, Inc. | Method and system for treating valve stenosis |
US9149277B2 (en) | 2010-10-18 | 2015-10-06 | Artventive Medical Group, Inc. | Expandable device delivery |
JP5636114B2 (en) | 2010-10-28 | 2014-12-03 | コヴィディエン リミテッド パートナーシップ | Substance removal device and method of use |
KR101518151B1 (en) | 2010-11-11 | 2015-05-06 | 코비디엔 엘피 | Flexible debulking catheters with imaging and methods of use and manufacture |
JP5980795B2 (en) | 2010-11-17 | 2016-08-31 | ボストン サイエンティフィック サイムド,インコーポレイテッドBoston Scientific Scimed,Inc. | Stent delivery system and method for manufacturing the same, and clip member assembly for use with the stent delivery system |
JP5891236B2 (en) | 2010-11-17 | 2016-03-22 | ボストン サイエンティフィック サイムド,インコーポレイテッドBoston Scientific Scimed,Inc. | Stent delivery system |
JP6081918B2 (en) | 2010-11-17 | 2017-02-15 | ボストン サイエンティフィック サイムド,インコーポレイテッドBoston Scientific Scimed,Inc. | Stent delivery system, locking member for preventing unintentional actuation of thumbwheel of stent delivery system and method for preventing |
EP2658484A1 (en) | 2010-12-30 | 2013-11-06 | Boston Scientific Scimed, Inc. | Multi stage opening stent designs |
WO2012119037A1 (en) | 2011-03-03 | 2012-09-07 | Boston Scientific Scimed, Inc. | Stent with reduced profile |
CA2823535A1 (en) | 2011-03-03 | 2012-09-07 | Boston Scientific Scimed, Inc. | Low strain high strength stent |
US10864106B2 (en) | 2011-03-08 | 2020-12-15 | W. L. Gore & Associates, Inc. | Medical device for use with a stoma |
WO2012125184A1 (en) * | 2011-03-16 | 2012-09-20 | Boston Scientific Scimed, Inc. | Stent and delivery system |
EP2693981A4 (en) | 2011-04-01 | 2015-07-01 | Univ Cornell | Method and apparatus for restricting flow through an opening in the side wall of a body lumen, and/or for reinforcing a weakness in the side wall of a body lumen, while still maintaining substantially normal flow through the body lumen |
US9138230B1 (en) | 2011-04-29 | 2015-09-22 | Avenu Medical, Inc. | Systems and methods for creating arteriovenous (AV) fistulas |
JP5806407B2 (en) | 2011-09-01 | 2015-11-10 | コヴィディエン リミテッド パートナーシップ | Catheter with helical drive shaft and manufacturing method |
US10058443B2 (en) | 2011-11-02 | 2018-08-28 | Boston Scientific Scimed, Inc. | Stent delivery systems and methods for use |
EP2773413B1 (en) | 2011-11-04 | 2020-01-08 | Avenu Medical, Inc. | Systems for percutaneous intravascular access and guidewire placement |
CA2863248C (en) | 2012-02-08 | 2020-07-21 | Caymus Medical, Inc. | Intravascular arterial to venous anastomosis and tissue welding catheter |
US9138569B2 (en) | 2012-02-29 | 2015-09-22 | SinuSys Corporation | Devices and methods for dilating a paranasal sinus opening and for treating sinusitis |
WO2013142386A1 (en) * | 2012-03-18 | 2013-09-26 | Avneri Itzhak | Devices and methods for endovascular access and therapy |
CA2873440C (en) | 2012-05-14 | 2020-06-02 | C.R. Bard, Inc. | Uniformly expandable stent |
US9532844B2 (en) | 2012-09-13 | 2017-01-03 | Covidien Lp | Cleaning device for medical instrument and method of use |
US9943329B2 (en) | 2012-11-08 | 2018-04-17 | Covidien Lp | Tissue-removing catheter with rotatable cutter |
US9439710B2 (en) | 2012-11-14 | 2016-09-13 | Avenu Medical, Inc. | Intravascular arterial to venous anastomosis and tissue welding catheter |
US9095344B2 (en) | 2013-02-05 | 2015-08-04 | Artventive Medical Group, Inc. | Methods and apparatuses for blood vessel occlusion |
US8984733B2 (en) | 2013-02-05 | 2015-03-24 | Artventive Medical Group, Inc. | Bodily lumen occlusion |
US10835367B2 (en) | 2013-03-08 | 2020-11-17 | Limflow Gmbh | Devices for fluid flow through body passages |
CN107432762B (en) | 2013-03-08 | 2021-04-13 | 林弗洛公司 | Methods and systems for providing or maintaining fluid flow through a body passageway |
USD723165S1 (en) | 2013-03-12 | 2015-02-24 | C. R. Bard, Inc. | Stent |
US9157515B2 (en) | 2013-03-15 | 2015-10-13 | American Axle & Manufacturing, Inc. | Axle assembly |
US9103427B2 (en) | 2013-03-15 | 2015-08-11 | American Axle & Manufacturing, Inc. | Axle assembly |
US9254713B2 (en) | 2013-03-15 | 2016-02-09 | American Axle & Manufacturing, Inc. | Axle assembly with inboard axle shaft bearings that support a differential mechanism |
US9687263B2 (en) | 2013-05-30 | 2017-06-27 | SinuSys Corporation | Devices and methods for inserting a sinus dilator |
US9636116B2 (en) | 2013-06-14 | 2017-05-02 | Artventive Medical Group, Inc. | Implantable luminal devices |
US9737306B2 (en) | 2013-06-14 | 2017-08-22 | Artventive Medical Group, Inc. | Implantable luminal devices |
US10149968B2 (en) | 2013-06-14 | 2018-12-11 | Artventive Medical Group, Inc. | Catheter-assisted tumor treatment |
US9737308B2 (en) | 2013-06-14 | 2017-08-22 | Artventive Medical Group, Inc. | Catheter-assisted tumor treatment |
US10070866B1 (en) | 2013-08-01 | 2018-09-11 | Avenu Medical, Inc. | Percutaneous arterial to venous anastomosis clip application catheter system and methods |
US20150065810A1 (en) * | 2013-08-28 | 2015-03-05 | SinuSys Corporation | Frontal Sinus Recess Dilator |
US9867694B2 (en) | 2013-08-30 | 2018-01-16 | Jenavalve Technology Inc. | Radially collapsible frame for a prosthetic valve and method for manufacturing such a frame |
US10117668B2 (en) | 2013-10-08 | 2018-11-06 | The Spectranetics Corporation | Balloon catheter with non-deployable stent having improved stability |
US9737696B2 (en) | 2014-01-15 | 2017-08-22 | Tufts Medical Center, Inc. | Endovascular cerebrospinal fluid shunt |
JP6637430B2 (en) | 2014-01-15 | 2020-01-29 | タフツ メディカル センター, インク.Tufts Medical Center, Inc. | Intravascular cerebrospinal fluid shunt |
US10772672B2 (en) | 2014-03-06 | 2020-09-15 | Avenu Medical, Inc. | Systems and methods for percutaneous access and formation of arteriovenous fistulas |
US10363043B2 (en) | 2014-05-01 | 2019-07-30 | Artventive Medical Group, Inc. | Treatment of incompetent vessels |
US11712230B2 (en) | 2014-05-02 | 2023-08-01 | W. L. Gore & Associates, Inc. | Occluder and anastomosis devices |
US11439396B2 (en) | 2014-05-02 | 2022-09-13 | W. L. Gore & Associates, Inc. | Occluder and anastomosis devices |
US9993251B2 (en) | 2014-05-02 | 2018-06-12 | W. L. Gore & Associates, Inc. | Anastomosis devices |
US9545263B2 (en) | 2014-06-19 | 2017-01-17 | Limflow Gmbh | Devices and methods for treating lower extremity vasculature |
WO2015200702A1 (en) | 2014-06-27 | 2015-12-30 | Covidien Lp | Cleaning device for catheter and catheter including the same |
WO2016070147A1 (en) | 2014-10-31 | 2016-05-06 | Cerevasc, Llc | Methods and systems for treating hydrocephalus |
US10159587B2 (en) | 2015-01-16 | 2018-12-25 | Boston Scientific Scimed, Inc. | Medical device delivery system with force reduction member |
US10314667B2 (en) | 2015-03-25 | 2019-06-11 | Covidien Lp | Cleaning device for cleaning medical instrument |
CN107530168B (en) | 2015-05-01 | 2020-06-09 | 耶拿阀门科技股份有限公司 | Device and method with reduced pacemaker ratio in heart valve replacement |
US10232082B2 (en) | 2015-06-29 | 2019-03-19 | 480 Biomedical, Inc. | Implantable scaffolds for treatment of sinusitis |
EP3313330A4 (en) | 2015-06-29 | 2019-03-20 | 480 Biomedical, Inc. | Scaffold loading and delivery systems |
EP4233873A3 (en) | 2015-06-29 | 2023-10-18 | Lyra Therapeutics, Inc. | Implantable scaffolds for treatment of sinusitis |
US10292721B2 (en) | 2015-07-20 | 2019-05-21 | Covidien Lp | Tissue-removing catheter including movable distal tip |
JP6531999B2 (en) | 2015-08-21 | 2019-06-19 | アベニュ メディカル インコーポレイテッド | Systems and methods for forming a percutaneous arteriovenous fistula |
US10314664B2 (en) | 2015-10-07 | 2019-06-11 | Covidien Lp | Tissue-removing catheter and tissue-removing element with depth stop |
JP6820612B2 (en) | 2015-10-30 | 2021-01-27 | セレバスク,インコーポレイテッド | Hydrocephalus treatment system and method |
US11351048B2 (en) | 2015-11-16 | 2022-06-07 | Boston Scientific Scimed, Inc. | Stent delivery systems with a reinforced deployment sheath |
US10267401B2 (en) | 2015-11-25 | 2019-04-23 | American Axle & Manufacturing, Inc. | Axle assembly |
US10973664B2 (en) | 2015-12-30 | 2021-04-13 | Lyra Therapeutics, Inc. | Scaffold loading and delivery systems |
US11065137B2 (en) | 2016-02-26 | 2021-07-20 | Boston Scientific Scimed, Inc. | Stent delivery systems with a reduced profile |
WO2017165777A1 (en) | 2016-03-25 | 2017-09-28 | American Axle & Manufacturing, Inc. | Disconnecting axle assembly |
US10813644B2 (en) | 2016-04-01 | 2020-10-27 | Artventive Medical Group, Inc. | Occlusive implant and delivery system |
WO2017195125A1 (en) | 2016-05-13 | 2017-11-16 | Jenavalve Technology, Inc. | Heart valve prosthesis delivery system and method for delivery of heart valve prosthesis with introducer sheath and loading system |
US11207503B2 (en) | 2016-11-11 | 2021-12-28 | Avenu Medical, Inc. | Systems and methods for percutaneous intravascular access and guidewire placement |
CN110392557A (en) | 2017-01-27 | 2019-10-29 | 耶拿阀门科技股份有限公司 | Heart valve simulation |
US10347710B2 (en) * | 2017-03-01 | 2019-07-09 | Globalfoundries Singapore Pte. Ltd. | Thin film resistor methods of making contacts |
EP4299086A2 (en) | 2017-04-10 | 2024-01-03 | LimFlow GmbH | Devices for treating lower extremity vasculature |
US11724075B2 (en) | 2017-04-18 | 2023-08-15 | W. L. Gore & Associates, Inc. | Deployment constraining sheath that enables staged deployment by device section |
US10201639B2 (en) | 2017-05-01 | 2019-02-12 | 480 Biomedical, Inc. | Drug-eluting medical implants |
US10350395B2 (en) * | 2017-06-23 | 2019-07-16 | Cook Medical Technologies Llc | Introducer for lumen support or dilation |
US10238513B2 (en) | 2017-07-19 | 2019-03-26 | Abbott Cardiovascular Systems Inc. | Intravascular stent |
CN109966017B (en) * | 2017-12-27 | 2021-08-27 | 先健科技(深圳)有限公司 | Covered stent |
US11013627B2 (en) | 2018-01-10 | 2021-05-25 | Boston Scientific Scimed, Inc. | Stent delivery system with displaceable deployment mechanism |
WO2019173784A1 (en) | 2018-03-08 | 2019-09-12 | Cerevasc, Llc | Systems and methods for minimally invasive drug delivery to a subarachnoid space |
US10704663B2 (en) | 2018-09-06 | 2020-07-07 | American Axle & Manufacturing, Inc. | Modular disconnecting drive module with torque vectoring augmentation |
US10927937B2 (en) | 2018-09-06 | 2021-02-23 | American Axle & Manufacturing, Inc. | Modular disconnecting drive module with torque vectoring augmentation |
AU2019359268A1 (en) | 2018-10-09 | 2021-04-08 | Limflow Gmbh | Devices and methods for catheter alignment |
WO2020168117A1 (en) | 2019-02-13 | 2020-08-20 | Boston Scientific Scimed, Inc. | Stent delivery systems |
US10702407B1 (en) * | 2019-02-28 | 2020-07-07 | Renata Medical, Inc. | Growth stent for congenital narrowings |
EP4051174A4 (en) * | 2019-11-01 | 2023-11-22 | LimFlow GmbH | Devices and methods for increasing blood perfusion to a distal extremity |
CA3201019A1 (en) | 2020-11-09 | 2022-05-12 | Venova Medical, Inc. | Endovascular implants and devices and methods for accurate placement |
Family Cites Families (97)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5370675A (en) | 1992-08-12 | 1994-12-06 | Vidamed, Inc. | Medical probe device and method |
US4739768B2 (en) | 1986-06-02 | 1995-10-24 | Target Therapeutics Inc | Catheter for guide-wire tracking |
US4800882A (en) | 1987-03-13 | 1989-01-31 | Cook Incorporated | Endovascular stent and delivery system |
DE3710913A1 (en) | 1987-04-01 | 1988-10-13 | Manfred Wolfgang Dr Helzel | PUNCTURE CATHETER |
CA2026604A1 (en) | 1989-10-02 | 1991-04-03 | Rodney G. Wolff | Articulated stent |
US5035706A (en) | 1989-10-17 | 1991-07-30 | Cook Incorporated | Percutaneous stent and method for retrieval thereof |
DE69118083T2 (en) | 1990-10-09 | 1996-08-22 | Cook Inc | Percutaneous stent assembly |
CA2060067A1 (en) | 1991-01-28 | 1992-07-29 | Lilip Lau | Stent delivery system |
US5135536A (en) | 1991-02-05 | 1992-08-04 | Cordis Corporation | Endovascular stent and method |
US5591172A (en) | 1991-06-14 | 1997-01-07 | Ams Medinvent S.A. | Transluminal implantation device |
US5527354A (en) | 1991-06-28 | 1996-06-18 | Cook Incorporated | Stent formed of half-round wire |
US5314472A (en) | 1991-10-01 | 1994-05-24 | Cook Incorporated | Vascular stent |
CA2380683C (en) | 1991-10-28 | 2006-08-08 | Advanced Cardiovascular Systems, Inc. | Expandable stents and method for making same |
FR2683449A1 (en) | 1991-11-08 | 1993-05-14 | Cardon Alain | ENDOPROTHESIS FOR TRANSLUMINAL IMPLANTATION. |
US5507767A (en) | 1992-01-15 | 1996-04-16 | Cook Incorporated | Spiral stent |
US5405377A (en) | 1992-02-21 | 1995-04-11 | Endotech Ltd. | Intraluminal stent |
FR2688401B1 (en) | 1992-03-12 | 1998-02-27 | Thierry Richard | EXPANDABLE STENT FOR HUMAN OR ANIMAL TUBULAR MEMBER, AND IMPLEMENTATION TOOL. |
US5540712A (en) | 1992-05-01 | 1996-07-30 | Nitinol Medical Technologies, Inc. | Stent and method and apparatus for forming and delivering the same |
US6336938B1 (en) | 1992-08-06 | 2002-01-08 | William Cook Europe A/S | Implantable self expanding prosthetic device |
EP0607468B1 (en) | 1992-12-16 | 1994-09-21 | Schneider (Europe) Ag | Stent placement instrument |
DE4303181A1 (en) | 1993-02-04 | 1994-08-11 | Angiomed Ag | Implantable catheter |
US5342801A (en) * | 1993-03-08 | 1994-08-30 | National Semiconductor Corporation | Controllable isotropic plasma etching technique for the suppression of stringers in memory cells |
WO1994023786A1 (en) | 1993-04-13 | 1994-10-27 | Boston Scientific Corporation | Prosthesis delivery system |
FR2710834B1 (en) | 1993-10-05 | 1995-12-22 | Guerbet Sa | Expandable tubular organ for intraluminal endoprosthesis, intraluminal endoprosthesis, manufacturing process. |
DE69419877T2 (en) * | 1993-11-04 | 1999-12-16 | Bard Inc C R | Fixed vascular prosthesis |
JP2703510B2 (en) * | 1993-12-28 | 1998-01-26 | アドヴァンスド カーディオヴァスキュラー システムズ インコーポレーテッド | Expandable stent and method of manufacturing the same |
EP0754016B1 (en) * | 1994-04-01 | 2003-07-09 | Prograft Medical, Inc. | Self-expandable stent and stent-graft |
JP2825452B2 (en) | 1994-04-25 | 1998-11-18 | アドヴァンスド カーディオヴァスキュラー システムズ インコーポレーテッド | Radiopak stent marker |
DE4418336A1 (en) | 1994-05-26 | 1995-11-30 | Angiomed Ag | Stent for widening and holding open receptacles |
US5609605A (en) | 1994-08-25 | 1997-03-11 | Ethicon, Inc. | Combination arterial stent |
US5591230A (en) | 1994-09-07 | 1997-01-07 | Global Therapeutics, Inc. | Radially expandable stent |
US5702419A (en) | 1994-09-21 | 1997-12-30 | Wake Forest University | Expandable, intraluminal stents |
US5545210A (en) | 1994-09-22 | 1996-08-13 | Advanced Coronary Technology, Inc. | Method of implanting a permanent shape memory alloy stent |
US5836965A (en) | 1994-10-19 | 1998-11-17 | Jendersee; Brad | Stent delivery and deployment method |
IL115756A0 (en) * | 1994-10-27 | 1996-01-19 | Medinol Ltd | Stent fabrication method |
CA2201128C (en) | 1994-10-27 | 2000-10-24 | Jeffrey A. Helgerson | Stent delivery device |
CA2134997C (en) | 1994-11-03 | 2009-06-02 | Ian M. Penn | Stent |
US5573508A (en) * | 1994-11-22 | 1996-11-12 | Advanced Cardiovascular Systems, Inc. | Catheter with an expandable perfusion lumen |
CA2301351C (en) | 1994-11-28 | 2002-01-22 | Advanced Cardiovascular Systems, Inc. | Method and apparatus for direct laser cutting of metal stents |
CA2163708C (en) * | 1994-12-07 | 2007-08-07 | Robert E. Fischell | Integrated dual-function catheter system for balloon angioplasty and stent delivery |
DE4446036C2 (en) | 1994-12-23 | 1999-06-02 | Ruesch Willy Ag | Placeholder for placement in a body tube |
US5591226A (en) | 1995-01-23 | 1997-01-07 | Schneider (Usa) Inc. | Percutaneous stent-graft and method for delivery thereof |
ATE220308T1 (en) | 1995-03-01 | 2002-07-15 | Scimed Life Systems Inc | LONGITUDONLY FLEXIBLE AND EXPANDABLE STENT |
US5591197A (en) | 1995-03-14 | 1997-01-07 | Advanced Cardiovascular Systems, Inc. | Expandable stent forming projecting barbs and method for deploying |
US5571168A (en) | 1995-04-05 | 1996-11-05 | Scimed Lifesystems Inc | Pull back stent delivery system |
BE1009278A3 (en) | 1995-04-12 | 1997-01-07 | Corvita Europ | Guardian self-expandable medical device introduced in cavite body, and medical device with a stake as. |
US5591198A (en) | 1995-04-27 | 1997-01-07 | Medtronic, Inc. | Multiple sinusoidal wave configuration stent |
AU5246696A (en) * | 1995-05-30 | 1996-12-12 | Ethicon Inc. | Single-walled balloon catheter with non-linear compliance characteristic |
DE69635112T2 (en) | 1995-07-07 | 2006-05-18 | W.L. Gore & Associates, Inc., Newark | INTERIOR COATING FOR TUBES AND BLOOD TUBES |
US5766203A (en) * | 1995-07-20 | 1998-06-16 | Intelliwire, Inc. | Sheath with expandable distal extremity and balloon catheters and stents for use therewith and method |
CN1208101C (en) | 1995-07-25 | 2005-06-29 | 梅德斯坦特有限公司 | Expansible stent |
US5628754A (en) | 1995-08-01 | 1997-05-13 | Medtronic, Inc. | Stent delivery guide catheter |
US5702418A (en) | 1995-09-12 | 1997-12-30 | Boston Scientific Corporation | Stent delivery system |
US5776161A (en) | 1995-10-16 | 1998-07-07 | Instent, Inc. | Medical stents, apparatus and method for making same |
US5591195A (en) | 1995-10-30 | 1997-01-07 | Taheri; Syde | Apparatus and method for engrafting a blood vessel |
US5925054A (en) * | 1996-02-20 | 1999-07-20 | Cardiothoracic Systems, Inc. | Perfusion device for maintaining blood flow in a vessel while isolating an anastomosis |
CA2192520A1 (en) * | 1996-03-05 | 1997-09-05 | Ian M. Penn | Expandable stent and method for delivery of same |
US5782825A (en) * | 1996-03-07 | 1998-07-21 | Miravant Systems, Inc. | Microlens tip assembly for light delivery catheter |
US5713949A (en) | 1996-08-06 | 1998-02-03 | Jayaraman; Swaminathan | Microporous covered stents and method of coating |
US6241760B1 (en) * | 1996-04-26 | 2001-06-05 | G. David Jang | Intravascular stent |
US5697971A (en) | 1996-06-11 | 1997-12-16 | Fischell; Robert E. | Multi-cell stent with cells having differing characteristics |
US5797920A (en) * | 1996-06-14 | 1998-08-25 | Beth Israel Deaconess Medical Center | Catheter apparatus and method using a shape-memory alloy cuff for creating a bypass graft in-vivo |
US5676670A (en) * | 1996-06-14 | 1997-10-14 | Beth Israel Deaconess Medical Center | Catheter apparatus and method for creating a vascular bypass in-vivo |
US5776140A (en) | 1996-07-16 | 1998-07-07 | Cordis Corporation | Stent delivery system |
US5922020A (en) * | 1996-08-02 | 1999-07-13 | Localmed, Inc. | Tubular prosthesis having improved expansion and imaging characteristics |
US5755781A (en) | 1996-08-06 | 1998-05-26 | Iowa-India Investments Company Limited | Embodiments of multiple interconnected stents |
US5800517A (en) | 1996-08-19 | 1998-09-01 | Scimed Life Systems, Inc. | Stent delivery system with storage sleeve |
EP0932377B1 (en) | 1996-08-23 | 2006-06-28 | Boston Scientific Scimed, Inc. | Stent delivery system having stent securement apparatus |
US5776183A (en) | 1996-08-23 | 1998-07-07 | Kanesaka; Nozomu | Expandable stent |
US5980530A (en) | 1996-08-23 | 1999-11-09 | Scimed Life Systems Inc | Stent delivery system |
DK176341B1 (en) | 1996-09-06 | 2007-08-27 | Cook William Europ | Aggregate for transluminal insertion of a tubular stent and an endovascular graft device |
US5911752A (en) * | 1996-09-13 | 1999-06-15 | Intratherapeutics, Inc. | Method for collapsing a stent |
US5772669A (en) | 1996-09-27 | 1998-06-30 | Scimed Life Systems, Inc. | Stent deployment catheter with retractable sheath |
US5755776A (en) | 1996-10-04 | 1998-05-26 | Al-Saadon; Khalid | Permanent expandable intraluminal tubular stent |
US6432127B1 (en) | 1996-10-11 | 2002-08-13 | Transvascular, Inc. | Devices for forming and/or maintaining connections between adjacent anatomical conduits |
US5868781A (en) | 1996-10-22 | 1999-02-09 | Scimed Life Systems, Inc. | Locking stent |
WO1998020810A1 (en) * | 1996-11-12 | 1998-05-22 | Medtronic, Inc. | Flexible, radially expansible luminal prostheses |
US5843027A (en) * | 1996-12-04 | 1998-12-01 | Cardiovascular Dynamics, Inc. | Balloon sheath |
JP3519565B2 (en) * | 1997-01-24 | 2004-04-19 | 株式会社パイオラックス | Stent |
US6206911B1 (en) * | 1996-12-19 | 2001-03-27 | Simcha Milo | Stent combination |
US5779731A (en) | 1996-12-20 | 1998-07-14 | Cordis Corporation | Balloon catheter having dual markers and method |
DE29702671U1 (en) | 1997-02-17 | 1997-04-10 | Jomed Implantate Gmbh | Stent |
US5815904A (en) * | 1997-03-13 | 1998-10-06 | Intratherapeutics, Inc. | Method for making a stent |
US5810872A (en) | 1997-03-14 | 1998-09-22 | Kanesaka; Nozomu | Flexible stent |
US5792144A (en) * | 1997-03-31 | 1998-08-11 | Cathco, Inc. | Stent delivery catheter system |
FR2762777B1 (en) * | 1997-05-05 | 1999-10-22 | Patrick Sabaria | VASCULAR AND CORONARY EXTENDERS, USUALLY DESIGNATED UNDER THE NAME OF "STENT" |
US5891154A (en) * | 1997-05-06 | 1999-04-06 | Advanced Cardiovascular System, Inc. | Passive perfusion stent delivery system |
US5741327A (en) | 1997-05-06 | 1998-04-21 | Global Therapeutics, Inc. | Surgical stent featuring radiopaque markers |
US5913895A (en) * | 1997-06-02 | 1999-06-22 | Isostent, Inc. | Intravascular stent with enhanced rigidity strut members |
US5855600A (en) * | 1997-08-01 | 1999-01-05 | Inflow Dynamics Inc. | Flexible implantable stent with composite design |
KR20010082497A (en) * | 1997-09-24 | 2001-08-30 | 메드 인스티튜트, 인코포레이티드 | Radially expandable stent |
US6309414B1 (en) * | 1997-11-04 | 2001-10-30 | Sorin Biomedica Cardio S.P.A. | Angioplasty stents |
US6129755A (en) * | 1998-01-09 | 2000-10-10 | Nitinol Development Corporation | Intravascular stent having an improved strut configuration |
US6342067B1 (en) * | 1998-01-09 | 2002-01-29 | Nitinol Development Corporation | Intravascular stent having curved bridges for connecting adjacent hoops |
US5938697A (en) * | 1998-03-04 | 1999-08-17 | Scimed Life Systems, Inc. | Stent having variable properties |
US5911754A (en) * | 1998-07-24 | 1999-06-15 | Uni-Cath Inc. | Flexible stent with effective strut and connector patterns |
US6273911B1 (en) * | 1999-04-22 | 2001-08-14 | Advanced Cardiovascular Systems, Inc. | Variable strength stent |
-
1998
- 1998-06-02 US US09/089,032 patent/US6330884B1/en not_active Expired - Lifetime
-
1999
- 1999-05-13 JP JP2000551692A patent/JP4498604B2/en not_active Expired - Lifetime
- 1999-05-13 CA CA002333764A patent/CA2333764A1/en not_active Abandoned
- 1999-05-13 WO PCT/US1999/010645 patent/WO1999062430A1/en active IP Right Grant
- 1999-05-13 AU AU41875/99A patent/AU751389B2/en not_active Ceased
- 1999-05-13 EP EP99925626.6A patent/EP1082070B1/en not_active Expired - Lifetime
-
2001
- 2001-08-20 US US09/933,295 patent/US6613081B2/en not_active Expired - Fee Related
-
2003
- 2003-07-09 US US10/617,105 patent/US6863684B2/en not_active Expired - Lifetime
Also Published As
Publication number | Publication date |
---|---|
JP2002516704A (en) | 2002-06-11 |
WO1999062430A1 (en) | 1999-12-09 |
EP1082070A4 (en) | 2009-07-22 |
EP1082070B1 (en) | 2016-08-31 |
EP1082070A1 (en) | 2001-03-14 |
US6863684B2 (en) | 2005-03-08 |
US20020111672A1 (en) | 2002-08-15 |
US6613081B2 (en) | 2003-09-02 |
US20040015225A1 (en) | 2004-01-22 |
AU4187599A (en) | 1999-12-20 |
JP4498604B2 (en) | 2010-07-07 |
US6330884B1 (en) | 2001-12-18 |
AU751389B2 (en) | 2002-08-15 |
Similar Documents
Publication | Publication Date | Title |
---|---|---|
AU751389B2 (en) | Deformable scaffolding multicellular stent | |
US11911304B2 (en) | Apparatus and methods for delivering stents | |
ES2662946T3 (en) | Directional expansion of intraluminal devices | |
JP4156371B2 (en) | Balloon catheter / stent delivery device with protrusions | |
JP4671960B2 (en) | Apparatus and method for deploying an artificial blood vessel | |
US4739762A (en) | Expandable intraluminal graft, and method and apparatus for implanting an expandable intraluminal graft | |
US9700448B2 (en) | Devices and methods for controlling expandable prostheses during deployment | |
US6368345B1 (en) | Methods and apparatus for intraluminal placement of a bifurcated intraluminal garafat | |
EP0872220A1 (en) | Sheath and method of use for a stent delivery system | |
US20070173921A1 (en) | Flared stents and apparatus and methods for delivering them | |
AU741328B2 (en) | Microporous stent and implantation device | |
CA2528243A1 (en) | Stent deployment systems and methods | |
US20100241069A1 (en) | Ostial lesion stent delivery system | |
US20040102831A1 (en) | Stent having tapered edges | |
WO2004021929A1 (en) | Modular stent system and delivery means | |
JP2003190297A (en) | Method and device for disposing forked in-vessel graft in vessel | |
MXPA98003110A (en) | Lining and method of use for an endoprote supply system |
Legal Events
Date | Code | Title | Description |
---|---|---|---|
FZDE | Discontinued |