JP2000316982A - Branch stent with modified side branch opening and its manufacturing method - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a branch stent which is inserted in a branch blood vessel by rounding edge parts of each thin plate of longitudinal direction and forming a tube by dint of forming a connecting part by welding, making a tube which is worked as an axial part of the large thin plate and making a tube which is worked as a leg part of the other thin plate then connecting the two leg parts with the axial part. SOLUTION: A branch stent 5 provides the first leg part 10, the second leg part 15 and the axis 20. Size of the first and second thin plates is almost the same so as to form the almost same size of the leg parts 10 and 15. The third thin plate is formed into size of which an inner section is corresponding to an outer periphery of the sections of the first and second leg parts 10 and 15 when it is rounded. After when the thin plates are formed, they are rounded so that they form a cylinder by dint of being fit their opposite edges. The edges of the thin plates are connected through a welding beed then the first and second leg parts 10 and 15 and the axis part 20 are formed. The first and second leg parts 10 and 15 and the axis part 20 have proximal and distal edges respectively and specify longitudinal lumens. The branch stent 5 connects the proximal end of the first and second leg parts 10 and 15 with the distal end of the axis part 20 so that the longitudinal lumens are connected with each other.

Description

DETAILED DESCRIPTION OF THE INVENTION

FIELD OF THE INVENTION The present invention relates to stents and, more particularly, to a bifurcated stent and a method of making a bifurcated stent for insertion into a bifurcated vessel.

BACKGROUND OF THE INVENTION Stents are well known in the art. It is usually formed of a cylindrical wire mesh that can be stretched by applying pressure inside. Alternatively, it can be formed of a cylindrically wound wire or a sheet of cylindrically formed material. Stents are usually inserted into a body vessel, such as the vasculature, where sections of the vessel collapse, sections that are partially occluded,
Strengthen weakened or abnormally stretched sections.
Stents have also been successfully implanted in other areas, such as the urethra and bile ducts, to strengthen such body vessels.

SUMMARY OF THE INVENTION U.S. Pat. No. 4,994,071
MacGregor discloses an expandable bifurcated stent having a primary cylindrical lattice formed from a flexible wire. Two additional cylindrical grids, smaller in diameter than the main grid, are similarly constructed. The primary grid includes flex lines interconnecting the primary grid with one of the additional grids. A second flexible wire interconnects the primary grid to the other additional grid. The flexible lines form a trunk that extends axially along the length of the main grid and along each of the additional grids. One disadvantage of this bifurcated stent is the complex nature of interconnecting the flexible wires that form the trunk with the loop structure of each lattice.

SUMMARY OF THE INVENTION The present invention provides a bifurcated stent and a method of making and deploying a bifurcated stent having a shaft portion and two leg portions, thereby providing the above and other prior art techniques. Solve the shortcomings. In a first embodiment of the present invention, a bifurcated stent is made by providing three sheets that are patterned to a desired pattern, where the two sheets are approximately the same size, The sheets are wider than either of the first two sheets.
Each lamella forms a tube by rounding its longitudinal edges and forming a joint by welding. The larger sheet forms a tube that serves as the stem of the bifurcated stent, and the other sheet forms a tube that serves as the leg of the bifurcated stent. Next, the two leg portions are joined to the shaft portion to form a bifurcated stent. In the second embodiment of the present invention, a bifurcated stent is formed by preparing two stent plates. For each lamella, the longitudinal edges of a portion of the lamella are rounded and secured together to form one of the two leg portions of the bifurcated stent. The remaining free edges of each of the two sheets are then joined to form the axial portion of the stent. In a third embodiment, a bifurcated stent comprises first and second tubular portions.
The first portion has a proximal end forming a shaft portion and a distal end forming one of the leg portions of the bifurcated stent. A branch is located between the proximal and distal ends of the first portion. The second portion is advanced through the ostium to introduce the second portion into the longitudinal lumen of the shaft portion of the first portion and project beyond the ostium to form a second leg. As the second portion is extended, the proximal end of the second portion engages the material defining the ostium to secure the second leg in the desired position. A) providing a first sheet having a first edge, a second edge, a third edge, and a fourth edge in a method of making a bifurcated stent; b) a first edge, a second edge.
Providing a second sheet having an edge, a third edge and a fourth edge; c) providing a third sheet having a first edge, a second edge, a third edge and a fourth edge; and d). Attaching a second edge of the first lamella to a third edge to form a tubular first leg portion having a proximal end and a distal end;
Attaching a second edge of the sheet to a third edge to form a tubular second leg portion having a proximal end and a distal end;
f) attaching a second edge of the third sheet to the third edge to form a tubular shaft portion having a proximal end and a distal end; g) a proximal edge and a second leg of the first leg portion. Attaching the proximal edge of the portion to the distal end of the shaft portion. A method of making a bifurcated stent, comprising: a) a first having a proximal end and a distal end;
Providing a sheet; b) deforming the distal end of the first sheet to form a first leg; deforming the proximal end of the first sheet to form a first shaft half; c. A) providing a second sheet having a proximal end and a distal end;
Deforming the distal end of the sheet to form a second leg and deforming the proximal end of the second sheet to form a second shaft half;
e) joining the first shaft half to the second shaft half to form a shaft. It is another object of the present invention to provide a method comprising: In the method of making a bifurcated stent, a)
Providing a first extensible tubular member having a proximal end and a distal end and a longitudinal lumen therethrough, wherein the first tubular member has a port between the proximal end and the distal end. Positioning, the ostium communicates with the longitudinal lumen, the mouth is sized to receive and secure the second extensible tubular member, and b) the first extensible member Distributing the first extensible tubular member to a branch conduit having a first lumen and a second lumen such that the branch is in communication with the second lumen, and c) is disposed within the first lumen; c). Extending the first extensible member by an amount sufficient to secure the first extensible member in the first lumen; and d) a second end having a proximal end and a distal end and a longitudinal lumen therethrough. 2) providing an extensible tubular member; e) widening the limb; and f) the distal end of the second extensible tubular member is second. Distributing the second expandable tubular member into the ostium such that the proximal end of the second expandable tubular member is positioned within the longitudinal lumen of the first longitudinal member; Extending the second extensible tubular member by an amount sufficient to secure the extensible tubular member within the second lumen and the ostium. Is the purpose. A method of making a bifurcated stent, comprising: a) providing a lamella having a proximal end, a distal end, a longitudinal axis, and a circumferential axis, wherein the lamella has a proximal end and a distal end. A first side having a portion, a distal portion having a proximal end and a distal end, and a second side having a proximal end and a distal end, wherein the second side is proximal to the lamina. A third side having a proximal end and a distal end disposed between the end and the distal end of the lamella, the third side being remote from the distal end of the second side and the lamella. And a fourth side disposed between the proximal end of the proximal portion of the first side and the proximal end of the second side, and a fourth side of the first side. Providing a fifth side disposed between the distal end of the distal portion and the distal end of the third side;
The fifth side has a length shorter than the length of the fourth side, and further includes a sixth side disposed between the second side and the third side; Attaching the two sides to the proximal portion of the first side and attaching the third side to the distal portion of the first side to form a first extensible tubular member having a longitudinal lumen defining a longitudinal axis. A fourth side defining a proximal opening of the stent in communication with the longitudinal lumen, a fifth side defining a distal opening of the stent in communication with the longitudinal lumen, and a sixth side. The proximal end of the third side and the proximal end of the distal portion of the first side are sized to receive and secure the second expandable tubular member in communication with the longitudinal lumen. C) a first extensible tubular member is disposed within the first lumen;
Delivering the first expandable tubular member to a branch conduit having a first lumen and a second lumen such that the ostium communicates with the second lumen; d) connecting the first expandable tubular member to the first tube. Elongating the first expandable tubular member by an amount sufficient to lock into the cavity; e) providing a second expandable tubular member having a proximal end and a distal end and a longitudinal lumen therethrough. And f) a distal end of the second expandable tubular member is positioned within the second lumen and a proximal end of the second expandable tubular member is positioned within the longitudinal lumen of the first tubular member. Delivering the second expandable tubular member into the branch of the first tubular member so as to: g) an amount sufficient to secure the second expandable tubular member within the second lumen and the branch. It is yet another object of the present invention to provide a method that includes the step of stretching the second expandable tubular member. A bifurcated stent, comprising: a) a first tubular member having a proximal end and a distal end and a longitudinal lumen therethrough defining a longitudinal axis, the first tubular member comprising a proximal end, a distal end, a longitudinal end; A first side having an axis, and a sheet having a circumferential axis, the sheet having a proximal portion having a proximal end and a distal end, and a distal portion having a proximal end and a distal end. And a second side having a proximal end and a distal end, wherein the second side is disposed between the proximal end of the lamella and the distal end of the lamella, and further comprising a proximal end and a distal end. A third side having an end, the third side being disposed between a distal end of the second side and a distal end of the sheet, and a proximal end of a proximal portion of the first side. And a fourth side disposed between the second side and the proximal end of the second side.
A side, a distal end of a distal portion of the first side, and a fifth side disposed between the distal end of the third side, the fifth side comprising a fourth side. Having a length shorter than the length of the
A sixth side disposed between the side and the third side; and b) a second side proximal to the first side and a third side first.
Means for attaching to a distal portion of the side, such that the fourth side defines a proximal opening of the stent in communication with the longitudinal lumen;
A fifth side defines a distal port of the stent that communicates with the longitudinal lumen, and a proximal end of the sixth and third sides and a proximal end of the distal portion of the first side are longitudinally defined. Communicating with the lumen, defining a side branch so sized to receive and secure the second tubular member; and c) defining the proximal and distal ends and the longitudinal lumen therethrough. A second tubular member having a bifurcated stent disposed within the ostium such that a proximal end of the second tubular member is disposed within a longitudinal lumen of the first tubular member. Provision is yet another object of the present invention. A method of making a bifurcated stent, comprising: a) cutting a proximal member from a first expandable tube having a first cross-sectional diameter, wherein the proximal member includes a proximal end and a distal end and a longitudinal end therethrough. B) cutting the distal member from a second extendable tube having a second cross-sectional diameter smaller than the first diameter of the first tube, the distal member having a cavity,
The distal member has a proximal end and a distal end and a longitudinal lumen therethrough, and c) the longitudinal lumen of the proximal member is in fluid communication with the longitudinal lumen of the distal member; Attaching a portion of the distal end of the proximal member to a portion of the proximal end of the distal member to form a first extensible tubular member having an end and a distal end and a longitudinal lumen therethrough; An unattached portion at the distal end of the proximal member and an unattached portion at the proximal end of the distal member communicate with the longitudinal lumen of the first tubular member to receive and secure the second extensible tubular member. Sized to define a side branch so configured; and c) a first extensible tubular member is disposed within the first lumen;
Delivering a first expandable tubular member to a branch conduit having a first lumen and a second lumen such that the ostium communicates with the second lumen; d) a first expandable tubular member into the first lumen. Elongating the first expandable tubular member by an amount sufficient to secure the tubular member; e) a second expandable tubular member having a proximal end and a distal end and having a longitudinal lumen therethrough. F) disposing the distal end of the second expandable tubular member within the second lumen and the proximal end of the second expandable tubular member inside the longitudinal lumen of the first tubular member. Delivering a second extensible tubular member into the branch of the first tubular member so as to be disposed at: g) securing the second tubular member within the second lumen and within the branch. It is a further object of the present invention to provide a method comprising the step of stretching the second expandable tubular member by an amount sufficient to . A bifurcated stent, comprising: a) a first tubular member having a proximal end and a distal end and a longitudinal lumen therethrough, the first tubular member comprising a proximal member and a distal member, the proximal member being a first member; The distal member has a cross-sectional diameter, a proximal end and a distal end and a longitudinal lumen therethrough, the distal member having a second cross-sectional diameter smaller than the first diameter, a proximal end and a distal end and a longitudinal lumen therethrough. And b) changing the distal end portion of the proximal member to the distal member such that the longitudinal lumen of the proximal member is in fluid communication with the longitudinal lumen of the distal member to form a first tubular member. Means for attaching to the proximal end portion of
An unattached portion of the proximal end of the proximal member and an unattached portion of the proximal end of the distal member communicate with the longitudinal lumen of the first tubular member to connect the second expandable tubular member. A second tubular member sized to receive and secure and defining a side branch adapted to do so, and c) comprising a second tubular member having a proximal end and a distal end and a longitudinal lumen therethrough. It is a further aspect of the present invention to provide a bifurcated stent in which a second tubular member is positioned and secured within a branch so that a proximal end of the member is positioned within a longitudinal lumen of the first tubular member. Is the purpose.

DESCRIPTION OF THE PREFERRED EMBODIMENTS In the embodiment shown in FIG. 1, the bifurcated stent 5 comprises a first leg 10, a second leg 15, and a shaft 20.
Is provided. FIG. 2 shows a first leg 10 used to form the first leg 10.
The second thin plate 3 used for forming the thin plate 25 and the second leg 15
0 and a third thin plate 35 used to form the shaft 20. The first thin plate 25 and the second thin plate 30 are substantially flat and have a predetermined length and width. In many applications, the first and second lamellas have approximately the same dimensions to produce approximately the same size legs 10 and 15, but the legs 10 and 15 and the lamellas 25 and 30 may be of various sizes depending on the particular application. Although the stents of the present invention may be sized to be their final size when assembled, in a preferred embodiment, the stent is expandable and sized to its final dimensions when expanded. ing. The stent plates 70 and 75 can be patterned or etched with perforations to create various patterns depending on the particular application to achieve the required extensible features as described above. . Third thin plate 3
5 is sized so that when it is rolled into a tube, the internal cross section can correspond to the cross-sectional profile of the first leg 10 and the second leg 15. The first thin plate 25 has a first edge 26, a second edge 27,
It has an edge 28 and a fourth edge 29. The second thin plate 30 includes a first edge 31, a second edge 32, a third edge 33, and a fourth edge 34.
Having. The third thin plate 35 has a first edge 36, a second edge 37, a third edge 38, and a fourth edge 39. After the sheet metal is cut to form the sheets 25, 30 and 35, they are deformed and rolled so that the opposing edges meet to create a cylindrical shape.
In the example shown in FIG. 2 and FIG.
To the edge 29 to form the first leg 10.
The rim 32 is connected to the rim 34 via the weld bead 19 and forms the second leg 15. The rim 37 is connected to the rim 39 via a weld bead 29 and forms the shaft 20. The edges may be joined in a wide variety of ways known to those skilled in the art, such as screwing, swaging, soldering, etc., suitable for this purpose, but in a preferred embodiment welding is used. In a particularly preferred embodiment, spot welding is used. As shown in FIG. 3, the first leg 10 has a proximal end 11, a distal end 12 and a longitudinal lumen 1
3 is specified. The second leg 15 has a proximal end 16 and a distal end 17
The shaft 20 defining the longitudinal lumen 18 has a proximal end 26, a distal end 27 and defines a longitudinal lumen 28. FIG. 4 shows the first leg 10, the second leg 15, and the shaft 20 immediately before assembly. To form the bifurcated stent 5, the longitudinal lumens 13, 18
The proximal end 11 of the first leg 10 and the proximal end 16 of the second leg are coupled to the distal end 27 of the shaft portion 20 so that and 28 communicate with each other. FIG. 5 is an end view of the assembled device,
FIG. 6 is a side view thereof. FIG. 11A shows a second embodiment of a bifurcated stent made according to the present invention. The stent 50 has a first leg 55 and a second leg 60 attached to a shaft portion 65. The bifurcated stent 50 is formed from a first thin plate and a second thin plate 75 as shown in FIG. 7A. The stent plates 70 and 75 can be patterned or etched with perforations to create various patterns depending on the particular application to achieve the required extensible features as described above. . Sheets 70 and 75 are substantially flat and have a predetermined length and width. The first thin plate 70 has a first edge 71, a second edge 72, a third edge 73, and a fourth edge 74. The second thin plate 75 has a first edge 76, a second edge 77, a third edge 78 and a fourth edge 79. To form the legs of the stent, a portion of edge 72 is rounded toward a portion of edge 74 and a portion of edge 77 is rounded toward a portion of edge 79. As shown in FIG.
Select partition points 80, 81, 82 and 83 above. The sections 80, 81, 82 and 83 are selected to suit the requirements of the particular application and can be adjusted according to the length required for the legs 55 and 60 and the length required for the shaft 65. Segment points 80 and 81 are equidistant from edges 73 and 71 and segment points 81 and 82 are edges 76 and 7
Equidistant from 8 results in a stent with legs 55 and 60 having a length approximately equal to shaft portion 65. If the segmentation points are selected to be closer to edges 73 and 78 than edges 71 and 76, the axis will have a length greater than the length of each leg. If the segmentation point is selected to be closer to edges 71 and 76 than edges 73 and 78, each of legs 60 and 65 will have a length greater than the length of shaft 65. However, in a preferred embodiment, the breakpoints 80,
81, 82 and 83 have proximal edges 72 ", 74", 7
7 "and 79" are selected to be approximately one-third the length of edges 72, 74, 77 and 79. 8, segment point 80 divides edge 72 approximately at its midpoint into a distal edge 72 'and proximal edge 72 ". Segment point 81 divides edge 74 approximately at its midpoint. , A distal edge 72 'and a proximal edge 74 ". Segment point 82 divides edge 77 approximately at its midpoint into a distal edge 77 'and a proximal edge 77 ", and segment point 83
Splits edge 79 approximately at its midpoint into a distal edge 79 'and a proximal edge 79 ". To form the stent, as shown in FIG. Rim 7
4 ', the first leg portion 55 and the first shaft half 65'
Is formed. The rim 77 'is joined to the rim 79' via a weld bead 91 to form a second member having a leg portion 60 and a second shaft half 65 ". As described above, the rim may be any of a variety of well known to those skilled in the art. Fig. 10A shows the first member 95 and the second member 100 shown in Fig. 9A in alignment just prior to assembly.
To make the bifurcated stent 50 shown in FIGS. 1A and 12A, the edge 72 "is welded to the edge 72" via the weld bead 92 such that the first shaft half 65 'and the second shaft half 65 "form the shaft 65.
9 "and the edge 74" through the weld bead 93 to the edge 7 ".
7A. FIG. 12A is an end cross-sectional view of the stent shown in FIG. 11A. In the embodiment shown in FIG. 7A, lamellas 70 and 75 are square or rectangular.
As shown in FIG. 7B, the sheets 70 and 75 are not limited to this shape. FIG. 11B shows a bifurcated stent made using the lamina 270 and 275 shown in FIG. 7B. The stent 250 includes a first leg 255 and a second leg 260 attached to the shaft portion 265. Branch stent 2
50 is formed from a first thin plate 270 and a second thin plate 275, as shown in FIG. 7B. The stent plates 270 and 275 can be sized and etched as described above. As shown in FIG. 7B, the first thin plate 2
70 has a first edge 271, a second edge 272, a third edge 273, a fourth edge 274, a fifth edge 275 and a sixth edge 276, a seventh edge 146, and an eighth edge 147. 2nd thin plate 275
Has a first edge 277, a second edge 278, a third edge 279, a fourth edge 280, a fifth edge 281, a sixth edge 282, a seventh edge 148, and an eighth edge 149. As shown in FIG.
74 is connected to the edge 276 via a weld bead 290;
First with a first leg 255 and a first shaft half 265 '
A member 295 is formed. Edge 280 is connected to edge 282 via weld bead 291 to form a second member 300 having a second leg portion 260 and a second shaft half 265 ".
As mentioned above, the edges may be connected in various ways well known to those skilled in the art. FIG. 10B shows the alignment of FIG.
The first member 295 and the second member 300 shown in FIG. To make the bifurcated stent shown in FIGS. 11B and 12B, a first shaft half 265 'and a second shaft half 265 "
65 through the weld bead 292 to form
72 is connected to edge 149 and edge 278 is connected to edge 147 via weld bead 293. FIG. 12B is an end cross-sectional view of the stent shown in FIG. 11B. FIG. 12C corresponds to FIG.
7A and 7B show alternative patterns that can be used instead of the pattern shown in FIG. 7B. A third embodiment of the present invention comprises two portions that are deployed sequentially in two steps and assembled within a patient to form a bifurcated stent. FIG.
Has a longitudinal lumen 131, a proximal edge 115 defining a shaft portion 125 and a distal end 12 defining a first leg portion 130.
Show the axis and the first leg portion 110 with zero. The second leg portion 140 has a longitudinal lumen 132 and has a proximal edge 145 and a distal edge 150. Shaft and first leg portion 110
And the second leg portion 140 can be sized and patterned or etched as described above. A branch 135 is disposed between the proximal edge 115 and the distal end 120 of the shaft and first leg portion 110. 135
Is sized to receive the second leg portion 140, and when the second leg portion 140 extends in the branch 135, meshes with the second leg portion 140 and is fixed. The second leg 140
When extended, it is sized to engage with the branch 135 and be fixed. 14 to 21
Shows how to assemble a bifurcated stent within a bifurcated lumen. As shown in FIGS. 14-21, the area to be treated is a branch lumen having a first or main lumen 190 and a second or branch lumen 195. As shown in FIG.
The first guide wire 155 is introduced into the main lumen 190 and the second guide wire 156 is introduced into the branch lumen 195. As shown in FIG. 15, a balloon-expandable shaft and first leg portion 110 are provided.
Is positioned at the distal end of the first balloon catheter 170 such that the balloon 175 is positioned within the longitudinal lumen 131. Next, a second balloon catheter 175 is introduced into the shaft and longitudinal lumen 131 of the first leg portion 110 and the balloon 1
Advance so that 76 is positioned in mouth 135. First
The catheter 170 is attached to the first guide wire 155 and the second
The catheter 171 is attached to the second guide wire 156. As shown in FIG. 16, the unextended shaft and first leg portion 110 should be treated such that first leg portion 130 is positioned within trunk lumen 190 and branch 135 communicates with branch lumen 195. Guide to the area. Guide wire 156 is connected to branch lumen 195.
Facilitates the orientation of the branch 135. Conventional catheter and balloon sizes are not scaled in proportion, and details well known to those skilled in the art have been omitted for clarity. The balloon 175 is inflated, thereby causing FIG.
The shaft and the first leg portion 110 are extended as shown in FIG. After extension, the shaft and first leg portion 11
The outer wall of 0 is in contact with the inner wall of the trunk lumen 190, but the gap is intentionally left out for clarity. While the balloon 175 of the first catheter 170 is inflated, the balloon 176 of the second catheter 171 is inflated, and the branch 135 is enlarged as shown in FIG. As the branch 135 expands, the portion of the stent defining the branch 135 is extruded to form a branch securing lip 180. Balloon 175
And 176 are retracted and second catheter 171 is withdrawn, leaving second guide wire 156 in place in branch lumen 195. Next, the second leg portion 140 is applied to the second catheter 171 such that the balloon 176 is positioned in the longitudinal lumen 132, and then the second catheter 171 is applied to the second guide wire 156. Next, as shown in FIG. 19, the second leg portion 140 is guided into and introduced into the shaft and the vertical lumen 131 of the first leg portion 110, and the distal end 150 of the second leg portion 140 is connected to the branch lumen. 195 and advanced through the branch 135 such that the proximal end 145 communicates with the longitudinal lumen 131. The balloon 176 on the second catheter 171 is partially inflated, and then the balloon 175 on the first catheter 170 is partially inflated to a pressure approximately equal to the pressure in the balloon 176. Next, balloons 175 and 176 are inflated to approximately equal pressures. When the balloon 176 on the second catheter 171 is inflated as shown in FIG.
The leg member 140 extends, so that the outer wall engages and is secured to the area surrounding the mouth 135. When the balloon 175 on the first catheter 170 is inflated, the balloon 1
The shaft and first leg portion 110 are prevented from collapsing upon expansion of 76. After extension, the outer wall of the second leg 140
5 is in contact with the inner wall, but the gap is intentionally left for clarity. The balloons 175 and 176 are deflated and the catheters 170 and 171 and the lead 155
And 156 are withdrawn and assembled into a bifurcated stent 16.
0 is left at a predetermined position as shown in FIG. Figures 22 to 31 illustrate a particularly preferred method of making a bifurcated stent according to the present invention. FIG. 22 shows the first extensible tubular member 30.
1 shows a thin plate 300 used for forming a thin film 1. Sheet 300 has a longitudinal axis 302, a circumferential axis 303, a proximal end 304, a distal end 3
05, a first side 306, a second side 307, a third side 308, a fourth side 309, a fifth side 310, and a sixth side 311. Although various patterns may be provided on the thin plate 300, in a preferred embodiment, the thin plate 300 includes the first tubular member 3.
A plurality of extensible cells 312 are provided that are substantially soft prior to extension of 01 and substantially rigid after extension of the first tubular member 301. In a particularly preferred embodiment, the soft cells 312 of the sheet 300 are substantially uniform, as shown in FIG. The first side 306 of the slat 300 has a proximal portion 313 having a proximal end 314 and a distal end 315. First side 306 also has a distal portion 316 having a proximal end 317 and a distal end 318. Second side 307 of sheet 300
Has a proximal end 319 and a distal end 320,
0 between the proximal end 304 and the distal end 305 of the lamella 300. The third side 308 of the sheet 300 is at the proximal end 32
1 and a distal end 3 of the second side 307 having a distal end 322.
20 and the distal end 305 of the lamella 300.
The fourth side 309 of the lamella 300 is located between the proximal end 314 of the proximal portion 313 of the first side 306 and the proximal end 319 of the second side 307. The fifth side 310 of the thin plate 300 is
The distal end 318 of the distal portion 316 of the side 306 and the third side 30
8, and a length L1 shorter than the length L2 of the fourth side 309 is provided. In a preferred embodiment, the length L1 of the fifth side 310 and the length L2 of the fourth side 309 are about 5: 7, that is, the fifth side 310 is about 70% of the length L2 of the fourth side 309. It has a length L1. In a particularly preferred embodiment, a plurality of substantially uniform cells 312 are etched into the sheet 300 as described above and the fifth side 31 is etched.
The number of cells arranged along the 0 circumferential axis 303;
The number of cells arranged along the circumferential axis 303 on the fourth side 309 is in a ratio of about 5: 7. The sixth side is the second side 3
07 and the third side 308. In a particularly preferred embodiment, the first side 306, the second side 307 and the third side
The sides 308 are substantially parallel to each other, the fourth side 309, the fifth side 3
10 and the sixth side 311 are substantially parallel to each other, and the first side 3
06, the second side 307 and the third side 308
9, substantially perpendicular to the fifth side 310 and the sixth side 311; To make the first extensible tubular member 301, the second side 307 of the sheet 300 is attached to the proximal portion 313 of the first side 306 of the sheet 300 via attachment means, and the second side 307 of the sheet 300 is attached via attachment means. The third side 308 is the first of the thin plate 300
A first lumen 323 attached to the distal portion 316 of the side 306 and defining a longitudinal axis 324 as shown in FIG.
The extensible tubular member 301 is formed. The mounting steps are
Although various mounting means known to those skilled in the art may be performed as appropriate for this purpose, in a preferred embodiment the mounting step is performed using screwing, swaging, soldering, welding or spot welding. I do. FIG.
In the embodiment shown in FIG. 3, spot welding 325 is used. After attaching the side portions as described above, the fourth side 309 is inserted into the longitudinal lumen 32, as shown in FIGS.
A proximal tubular member port or stent port 32 in communication with 3
The fifth side 310 defines a distal tubular member or stent port 327 that communicates with the longitudinal lumen 323. The proximal end 321 of the sixth side 311 and the third side 308 and the proximal end 317 of the distal portion 316 of the fourth side 306
A side branch 328 is sized to receive and secure the second extensible tubular member 329 (shown in FIGS. 26-27) and to do so (as shown in FIGS. 23-26). . The branch 328 has a diameter D1 that is greater than the diameter D2 of the unstretched stent. That is, the branch 328
Is the first, both before and after the tubular member 301 is extended.
Proximal and distal ports 326 and 327 of tubular member 301
Greater than. Next, the first expandable tubular member 301 is connected to the first and second lumens such that the first expandable tubular member is disposed within the first lumen and the branch communicates with the second lumen. To the branch conduit that has. In a preferred embodiment, delivery is via a balloon catheter as described above. After deployment, the first expandable tubular member is extended by an amount sufficient to secure the first expandable tubular member in the first lumen. Next, a second extensible tubular member 329 having a proximal end 330 and a distal end 331 and having a longitudinal lumen 332 therethrough is provided. The second extensible tubular member 329 (shown in FIGS. 25, 26, and 27) may be patterned in the same manner as the thin plate 300 described above. In a preferred embodiment,
Thin plate 300 used for producing first extensible tubular member 301
Cell 312 and cell 31 of second extensible tubular member 329
2 'is almost the same. Second extensible tubular member 329
To the vertical lumen 3 of the first tubular member 301 as shown in FIG.
23, and is advanced into and beyond the branch 328 as shown in FIG. 26, so that the distal end 331 of the second expandable tubular member 329 is positioned within the second lumen and The proximal end 330 of the bi-extensible tubular member 329 is disposed within the longitudinal lumen 323 of the first tubular member 301. Next, as shown in FIG. 27, the second expandable tubular member 329 is secured in an amount sufficient to secure the second expandable tubular member 329 in the second lumen and the branch 328 of the first tubular member. The member 329 is extended.
An advantage provided by this embodiment is that the stent provides a large branch that facilitates introduction of the second tubular member into the side branch or lumen. The stent is also particularly suitable for deploying a bifurcated stent continuously or placing the stent around a side branch prior to occlusion. 28 to 31 show an alternative embodiment of the first tubular member shown in FIGS. 23 to 27 and an alternative method of making the same. In this embodiment, the first tubular member 400
29 (shown in FIG. 29), as shown in FIG.
A proximal member 401 having a proximal end 405 and a distal member 404 having a proximal end 405 and a distal end 406. Proximal member 401 has a longitudinal lumen 415 and a first
It is cut from the first tube 407 having a cross-sectional diameter D1. Distal member 404 has a longitudinal lumen 416 and a second cross-sectional diameter D2.
From the second tube 408 having D2 is smaller than D1. Tubes 401 and 404 can be etched or patterned as described above prior to cutting proximal member 401 and distal member 404 from tubes 407 and 408. To create the first tubular member 400, a portion of the distal end 403 of the proximal member 401 is attached to a portion of the proximal end 405 of the distal member 404 via attachment means 417, as shown in FIG. Having a proximal end 409 and a distal end 410 and a longitudinal lumen 411 therethrough.
A tubular member 400 is formed. Members 401 and 404
Can be mounted using various mounting means 417 as described above, but in a preferred embodiment,
The attachment means used is welding. In a particularly preferred embodiment, spot welding is used. Since D2 is smaller than D1, the unattached portion of the distal end 403 of the proximal portion 401 and the unattached portion of the proximal end 405 of the distal portion 404 are shown in FIGS. 29 and 30A (end view of FIG. 29). As shown by, a branch 412 is defined. In some applications, it may be desirable for the portion where the distal end 403 of the proximal member 401 and the proximal end 405 of the distal member 404 contact each other to increase the strength of the first tubular member 400. . This may, for example, change the distal end 403 to the proximal end 40
This is achieved by deforming the distal end 403 of the proximal member 401 and the proximal end 405 of the distal member 404 prior to attachment to 5 to increase the surface area in alignment and contact.
FIG. 30B is an end view of this embodiment, showing a distal end 403 and a proximal end 40 compared to the embodiment shown in FIG. 30A.
5 indicates that the surface area for mounting 5 is large. FIG. 30B
Also shows that in this embodiment the branch 412 'is larger than the branch 412 shown in FIG. 30A. Next, the second tubular member 412 can be introduced into the branches 412 and 412 ′, and the second tubular member 413 is inserted into the longitudinal lumen 411 as described above.
To form a bifurcated stent 414 (shown in FIG. 31).

[Brief description of the drawings]

FIG. 1 shows a bifurcated stent made in accordance with the present invention.

FIG. 2 shows a sheet used to form the legs and shaft of the stent shown in FIG.

FIG. 3 shows the sheet shown in FIG. 2 after being rolled into a tube shape.

FIG. 4 is a perspective view of the tube shown in FIG. 3 before assembly.

FIG. 5 after being assembled to form a stent.
5 is an end view of the tube shown in FIG.

6 is a top view of the assembled device shown in FIG.

FIG. 7 shows a sheet used to form each alternative embodiment of a bifurcated stent made in accordance with the present invention.

FIG. 8 shows the sheet of FIG. 7A with a breakpoint.

9A shows the sheet of FIG. 8 after being rolled into a tubular shape, and FIG. 9B shows the sheet of FIG. 7B after being rounded into a tubular shape.

FIG. 10A shows the tube of FIG. 9A just before assembly, and FIG. 10B shows the tube of FIG. 9B just before assembly.

FIG. 11A is a side view of the tube shown in FIGS. 9A and 10A after assembly, and FIG. 11B is a side view of the tube shown in FIGS. 9B and 10B after assembly.

12A is an end view of the assembled device shown in FIG. 11A, FIG. 12B is an end view of the assembled device shown in FIG. 11B, and FIG. 12C is a pattern shown in FIGS. 7A and 7B. Fig. 4 shows an alternative embodiment of a pattern that can be used instead of.

FIG. 13 illustrates a shaft and first and second leg portions used to form another embodiment of a bifurcated stent made in accordance with the present invention.

FIG. 14 shows lead wires placed in the trunk lumen and branch lumen to be treated.

FIG. 15 shows the shaft and the first shaft shown in FIG. 13 placed on the catheter and guide wire before introduction into the lumen to be treated.
The legs are shown.

FIG. 16 shows the shaft and first leg shown in FIG. 13 after delivery to the bifurcation to be treated and before extension.

17 shows the second leg portion shown in FIG. 16 after extension.

FIG. 18 shows branch extension.

FIG. 19 shows the unstretched second leg portion located at the branch.

FIG. 20 illustrates the extension of the second leg portion shown in FIG.

FIG. 21 shows an assembled bifurcated stent placed in a bifurcation lumen to be treated.

FIG. 22 shows a sheet used to form a first extensible tubular member.

FIG. 23 shows the sheet of FIG. 22 after forming into a first extensible tubular member.

FIG. 24 shows the first expandable tubular member of FIG. 23 with the catheter inserted into the longitudinal lumen and the side branch.

FIG. 25 shows the first extensible tubular member of FIG. 24 after being extended, with the second tubular member that has not been extended introduced into the side branch.

FIG. 26 shows the first extensible tubular member of FIG. 24 after extension, with the second tubular member that has not been extended positioned at the side branch.

FIG. 27 shows the second tubular member of FIG. 26 after extension.

FIG. 28 shows a side view of the proximal and distal members used to make an alternative embodiment of the present invention.

FIG. 29 shows the proximal and distal members of FIG. 28 after being connected to form a first extensible tubular member.

30A is an end view of FIG. 29, and FIG. 30B
FIG. 30 is an end view of FIG. 29 showing an alternative embodiment in which a portion of the proximal member and a portion of the distal member have been deformed prior to attachment.

FIG. 31 shows the first extensible tubular member of FIG. 29 with the second extensible tubular member positioned at the side branch.

[Explanation of symbols]

5 bifurcated stent, 10 first leg, 11 proximal end, 12 distal end, 13 longitudinal lumen, 1
5 second leg, 16 proximal end, 17 distal end, 18 longitudinal lumen, 14 weld bead, 19
Welding bead, 20 axes, 25 first sheet,
26 first edge / proximal end, 27 second edge / distal end,
28 third edge / longitudinal lumen, 29 fourth edge / weld bead, 30 second sheet, 31 first edge, 32 second edge, 33 third edge, 34 fourth edge, 35
3rd thin plate, 36 1st edge, 37 2nd edge, 38
3rd edge, 39 4th edge, 50 stents,
55 first leg, 60 second leg, 65 shaft portion, 65 ′ first shaft half, 65 ″ second shaft half,
70 thin plate, 71 first edge, 72 second edge, 7
1 'distal edge, 72 "proximal edge, 73 third
Edge, 74 fourth edge 74, 74 'distal edge, 74 "
Proximal edge, 75 sheet, 76 first edge, 77
Second edge, 77 'distal edge, 77 "proximal edge, 78
3rd edge, 79 4th edge, 79 'distal edge, 7
9 "proximal edge, 80 segment points, 81 segment points,
82 section point, 83 section point, 90 weld bead, 91 weld bead, 95 first member, 1
00 second member, 110 shaft and first leg portion,
115 proximal edge, 120 distal end, 125
Shaft part, 131 longitudinal lumen, 132 longitudinal lumen,
135 branch, 140 second leg, 146
7th edge, 147 8th edge, 148 7th edge,
149 eighth edge, 150 distal end, 15
5 First lead wire, 156 Second lead wire, 170
1st balloon catheter, 171 2nd balloon catheter 175 balloon, 176 balloon, 180
Branch fixation lip, 190 trunk lumen, 195
Branch lumen, 250 stent, 255 first leg, 260 second leg, 265 axis, 265 '
First shaft half, 265 Second shaft half, 270 First
Thin plate, 271 first edge, 272 second edge,
273 third edge, 274 fourth edge, 275
Second sheet / fifth edge, 276 sixth edge, 277
First edge, 278 second edge, 279 third edge,
280 fourth edge, 281 fifth edge, 282
6th edge, 290 weld bead, 291 weld bead, 292 weld bead, 293 weld bead, 295 first member, 300 second member, 30
1 first extensible tubular member, 302 longitudinal axis, 3
03 circumferential axis, 304 proximal end, 305
Distal end, 306 first edge, 307 second edge,
308 third edge, 309 fourth edge, 310
5th edge, 311 6th edge, 312 cell, 313 proximal portion, 314 proximal end, 3
15 distal end, 316 distal portion, 317 proximal end, 318 distal end 319 proximal end, 3
20 distal end, 321 proximal end, 322 distal end, 323 longitudinal lumen, 324 longitudinal axis, 3
26 Stent port, 327 Stent port, 328
Branch, 329 second extensible tubular member, 330
Proximal end, 331 distal end, 332 longitudinal lumen,
400 first tubular member, 401 proximal member, 4
02 proximal end, 403 distal end, 404 distal member, 405 proximal end, 406 distal end,
407 first pipe, 408 second pipe, 409
Proximal end, 410 distal end, 411 longitudinal lumen, 412 branch, 415 longitudinal lumen, 41
6 vertical lumen, 417 mounting means

Claims (56)

[Claims] 1. A method of making a bifurcated stent, comprising: a) providing a lamina having a proximal end, a distal end, a longitudinal axis, and a circumferential axis, wherein the lamina has a proximal end and a distal end. A first side having a proximal portion having an end, a first side having a proximal end and a distal portion having a distal end, and a second side having a proximal end and a distal end. Is disposed between the proximal end of the lamella and the distal end of the lamella, and further comprising a third side having a proximal end and a distal end, the third side being distal of the second side. A fourth side disposed between the end and the distal end of the sheet, and further disposed between a proximal end of the proximal portion of the first side and a proximal end of the second side; Providing a fifth side disposed between the distal end of the distal portion of the first side and the distal end of the third side;
The fifth side has a length shorter than the length of the fourth side, and further includes a sixth side disposed between the second side and the third side; Attaching the two sides to the proximal portion of the first side and attaching the third side to the distal portion of the first side to form a first extensible tubular member having a longitudinal lumen defining a longitudinal axis. A fourth side defining a proximal opening of the stent in communication with the longitudinal lumen, a fifth side defining a distal opening of the stent in communication with the longitudinal lumen, and a sixth side. The proximal end of the third side and the proximal end of the distal portion of the first side are sized to receive and secure the second expandable tubular member in communication with the longitudinal lumen. C) a first extensible tubular member is disposed within the first lumen;
Delivering the first expandable tubular member to a branch conduit having a first lumen and a second lumen such that the ostium communicates with the second lumen; d) connecting the first expandable tubular member to the first tube. Elongating the first expandable tubular member by an amount sufficient to lock into the cavity; e) providing a second expandable tubular member having a proximal end and a distal end and a longitudinal lumen therethrough. And f) a distal end of the second expandable tubular member is positioned within the second lumen and a proximal end of the second expandable tubular member is positioned within the longitudinal lumen of the first tubular member. Distributing a second expandable tubular member into the branch of the first tubular member so as to: g) an amount sufficient to secure the second expandable tubular member within the second lumen and the branch. A method comprising extending a second extensible tubular member. 2. The method of claim 1, wherein the attaching step is performed using screwing. 3. The method of claim 1, wherein the attaching step is performed using swaging. 4. The method of claim 1, wherein the attaching step is performed using soldering. 5. The method of claim 1, wherein the attaching step is performed using welding. 6. The method of claim 1, wherein the step of welding is performed using spot welding. 7. The method of claim 1, wherein the fifth side has a length that is about 70% of the length of the fourth side. 8. The method of claim 1, further comprising providing first and second tubular members with a plurality of cells that are substantially soft prior to stretching and substantially rigid after stretching. the method of. 9. The method of claim 1, further comprising providing the sheet and the second tubular member with an etching pattern defining a plurality of cells. 10. The cell of claim 9, wherein the cell is substantially soft prior to extension of the first and second tubular members and substantially rigid after extension of the first and second tubular members. the method of. 11. The method of claim 10, wherein the cells of the sheet are substantially uniform. 12. The method of claim 10, wherein the cells of the second tubular member are substantially uniform. 13. The method of claim 10, wherein the cells of the sheet and the cells of the second tubular member are substantially uniform. 14. The number of cells arranged along a circumferential axis on a fifth side of the sheet and the number of cells arranged along a circumferential axis on a fourth side of the sheet. 12. The method of claim 11, wherein the ratio is about 5: 7. 15. The method of claim 1, wherein the ostium is larger than the proximal and distal ostia of the first tubular member. 16. The method of claim 1, wherein the first, second, and third sides are substantially parallel to each other, and the fourth, fifth, and sixth sides are substantially parallel to each other. 17. The method of claim 16, wherein the first, second and third sides are substantially perpendicular to the fourth, fifth and sixth sides. 18. A bifurcated stent, comprising: a) a first tubular member having a proximal end and a distal end and a longitudinal lumen therethrough defining a longitudinal axis, the first tubular member comprising a proximal end, A sheet having a distal end, a longitudinal axis, and a circumferential axis, the sheet comprising a proximal portion having a proximal end and a distal end, and a distal portion having a proximal end and a distal end. A first side having a proximal end and a second side having a distal end, wherein the second side is disposed between the proximal end of the lamella and the distal end of the lamella; A third side having a proximal end and a distal end, wherein the third side is disposed between the distal end of the second side and the distal end of the sheet, and further proximal to the first side. A fourth side disposed between the proximal end of the portion and the proximal end of the second side.
A side, a distal end of a distal portion of the first side, and a fifth side disposed between the distal end of the third side, the fifth side comprising a fourth side. Having a length shorter than the length of the
A sixth side disposed between the side and the third side; and b) a second side proximal to the first side and a third side first.
Means for attaching to a distal portion of the side, such that the fourth side defines a proximal opening of the stent in communication with the longitudinal lumen;
A fifth side defines a distal port of the stent that communicates with the longitudinal lumen, and a proximal end of the sixth and third sides and a proximal end of the distal portion of the first side are longitudinally defined. Communicating with the lumen, defining a side branch so sized to receive and secure the second tubular member; and c) defining the proximal and distal ends and the longitudinal lumen therethrough. A bifurcated stent disposed within a branch such that the second tubular member comprises a second tubular member having a proximal end of the second tubular member disposed within a longitudinal lumen of the first tubular member. 19. The method according to claim 18, wherein the attachment means is a screw.
A stent according to claim 1. 20. The method of claim 1, wherein the mounting means is a caulking.
9. The stent according to 8. 21. The method of claim 1, wherein the mounting means is a solder.
9. The stent according to 8. 22. The method according to claim 18, wherein the attachment means is welding.
A stent according to claim 1. 23. The stent according to claim 18, wherein the attachment means is spot welding. 24. The fifth side having a length of about 70 of the fourth side.
20. The stent of claim 18, wherein the stent has a percent length. 25. The stent of claim 18, wherein the first and second tubular members are provided with a plurality of cells that are substantially soft prior to stretching and substantially rigid after stretching. 26. The sheet metal and second tubular member comprising an etching pattern defining a plurality of cells.
9. The stent according to 8. 27. The cell of claim 26, wherein the cell is substantially soft prior to extension of the first and second tubular members and substantially rigid after extension of the first and second tubular members. Stent. 28. The stent of claim 27, wherein the cells of the lamina are substantially uniform. 29. The stent of claim 27, wherein the cells of the second tubular member are substantially uniform. 30. The stent of claim 27, wherein the cells of the sheet and the cells of the second tubular member are substantially uniform. 31. The number of cells arranged along the circumferential axis of the fifth side of the sheet and the number of cells arranged along the circumferential axis of the fourth side of the sheet: 29. The stent of claim 28, wherein the stent has a ratio of about 5: 7. 32. The stent of claim 18, wherein the branch is larger than the proximal and distal ports of the first tubular member. 33. The stent of claim 18, wherein the first, second and third sides are substantially parallel to each other and the fourth, fifth and sixth sides are substantially parallel to each other. 34. The stent of claim 33, wherein the first, second and third sides are substantially perpendicular to the fourth, fifth and sixth sides. 35. A kit for forming a bifurcated stent, comprising: a) a first expandable tubular member having a proximal end and a distal end and a longitudinal lumen defining a longitudinal axis therethrough;
The expandable tubular member comprises a slat having a proximal end, a distal end, a longitudinal axis, and a circumferential axis, the slat comprising a proximal portion having a proximal end and a distal end; A first side having a distal portion having a distal end, and a second side having a proximal end and a distal end, wherein the second side has a proximal end of the lamina and a distal end of the lamina. And a third side having a proximal end and a distal end, wherein the third side is disposed between the distal end of the second side and the distal end of the sheet. A fourth side disposed between the proximal end of the proximal portion of the first side and the proximal end of the second side; and a distal end of the distal portion of the first side. When,
A fifth side disposed between the third side and a distal end thereof, the fifth side having a length less than the length of the fourth side;
And a sixth side disposed between the second side and the third side, and b) a second side near the first side and a third side near the first side. 1
Means for attaching to a distal portion of the side, such that the fourth side defines a proximal opening of the stent in communication with the longitudinal lumen;
A fifth side defines a distal port of the stent that communicates with the longitudinal lumen, and a proximal end of the sixth and third sides and a proximal end of the distal portion of the first side are longitudinally defined. Defining a side branch so sized to receive and secure the second extensible tubular member in communication with the lumen; and c) a longitudinal and distal end therethrough. A second expandable tubular member having a cavity, wherein the second expandable tubular member comprises:
A proximal end of the second expandable tubular member is sized and disposed within the ostium such that the proximal end of the second expandable tubular member is disposed within the longitudinal lumen of the first tubular member; and A kit comprising: c) a first guide wire; d) a second guide wire; e) a first balloon catheter; f) a second balloon catheter. 36. A method of making a bifurcated stent, comprising: a) cutting a proximal member from a first expandable tube having a first cross-sectional diameter, the proximal member comprising a proximal end and a distal end; Having a longitudinal lumen therethrough, and b) cutting the distal member from a second expandable tube having a second cross-sectional diameter smaller than the first diameter of the first tube;
The distal member has a proximal end and a distal end and a longitudinal lumen therethrough, and c) the longitudinal lumen of the proximal member is in fluid communication with the longitudinal lumen of the distal member; Attaching a portion of the distal end of the proximal member to a portion of the proximal end of the distal member to form a first extensible tubular member having an end and a distal end and a longitudinal lumen therethrough; An unattached portion at the distal end of the proximal member and an unattached portion at the proximal end of the distal member communicate with the longitudinal lumen of the first tubular member to receive and secure the second extensible tubular member. Sized to define a side branch so configured; and c) a first extensible tubular member is disposed within the first lumen;
Delivering a first expandable tubular member to a branch conduit having a first lumen and a second lumen such that the ostium communicates with the second lumen; d) a first expandable tubular member into the first lumen. Elongating the first expandable tubular member by an amount sufficient to secure the tubular member; e) a second expandable tubular member having a proximal end and a distal end and having a longitudinal lumen therethrough. F) disposing the distal end of the second expandable tubular member within the second lumen and the proximal end of the second expandable tubular member inside the longitudinal lumen of the first tubular member. Delivering a second extensible tubular member into the branch of the first tubular member so as to be disposed at: g) securing the second tubular member within the second lumen and within the branch. Extending the second expandable tubular member by an amount sufficient for the method. 37. The method of claim 36, wherein the attaching step is performed using screwing. 38. The method of claim 36, wherein the attaching step is performed using swaging. 39. The method according to claim 36, wherein the attaching step is performed using soldering. 40. The method according to claim 36, wherein the attaching step is performed using welding. 41. The method of claim 40, wherein the step of welding is performed using spot welding. 42. The first and second tubular members further include:
37. The method of claim 36, comprising providing a plurality of cells that are substantially soft prior to stretching and substantially rigid after stretching. 43. The method of claim 36, further comprising providing the proximal member of the first tubular member, the distal member of the first tubular member, and the second tubular member with an etching pattern defining a plurality of cells. The described method. 44. The cell of claim 43, wherein the cell is substantially soft prior to extension of the first and second tubular members and substantially rigid after extension of the first and second tubular members. Method. 45. The method of claim 44, wherein the cells of the first tubular member and the cells of the second tubular member are substantially uniform. 46. A bifurcated stent, comprising: a) a first tubular member having a proximal end and a distal end and a longitudinal lumen therethrough, the first tubular member comprising a proximal member and a distal member; The distal member has a first cross-sectional diameter, proximal and distal ends and a longitudinal lumen therethrough, and the distal member has a second cross-sectional diameter smaller than the first diameter, proximal and distal ends and the same. B) passing through the distal end of the proximal member such that the longitudinal lumen of the proximal member is in fluid communication with the longitudinal lumen of the distal member to form a first tubular member. Means for attaching the portion to a portion of the proximal end of the distal member,
An unattached portion of the proximal end of the proximal member and an unattached portion of the proximal end of the distal member communicate with the longitudinal lumen of the first tubular member to connect the second expandable tubular member. A second tubular member sized to receive and secure and defining a side branch adapted to do so, and c) comprising a second tubular member having a proximal end and a distal end and a longitudinal lumen therethrough. A bifurcated stent in which a second tubular member is positioned and secured within a branch so that a proximal end of the member is positioned within a longitudinal lumen of the first tubular member. 47. The stent of claim 46, wherein the means for attaching is a screw. 48. The stent of claim 46, wherein the means for attaching is swaging. 49. The stent of claim 46, wherein the means for attaching is a solder. 50. The stent of claim 46, wherein the means for attaching is welding. 51. The method according to claim 5, wherein the welding is spot welding.
0. The stent according to 0. 52. The stent of claim 46, wherein the first and second tubular members comprise a plurality of cells that are substantially soft prior to stretching and substantially rigid after stretching. 53. The stent of embodiment 46, wherein the proximal member of the first tubular member, the distal member of the first tubular member, and the second tubular member comprise an etching pattern defining a plurality of cells. 54. The method of claim 53, wherein the plurality of cells are substantially soft prior to extension of the first and second tubular members and substantially rigid after extension of the first and second tubular members. The stent according to any of the preceding claims. 55. The stent of claim 54, wherein the cells of the first tubular member and the cells of the second tubular member are substantially uniform. 56. A kit for forming a bifurcated stent, comprising: a) a first expandable tubular member having a proximal end and a distal end and a longitudinal lumen defining a longitudinal axis therethrough;
The extendable tubular member comprises an extendable proximal member and an extendable distal member, the extendable proximal member having a first cross-sectional diameter, a proximal end and a distal end, and a longitudinal lumen therethrough. The distal member has a second cross-sectional diameter smaller than the first cross-sectional diameter, a proximal end and a distal end, and a longitudinal lumen therethrough; and b) the longitudinal lumen of the extendable proximal member is elongated. Attach a portion of the distal end of the extendable proximal member to a portion of the proximal end of the extendable distal member to communicate with a longitudinal lumen of the extendable distal member to form a first extendable tubular member. The unattached portion of the distal end of the extendable proximal member and the unattached portion of the proximal end of the extendable distal member are in communication with the longitudinal lumen of the first extendable tubular member. And defining a side branch adapted to receive and secure the second extensible tubular member, and End and a distal end and a second an extending tubular member having a longitudinal lumen therethrough, the second an extending tubular member,
A proximal end of the second expandable tubular member is sized and disposed within the ostium such that the proximal end of the second expandable tubular member is disposed within the longitudinal lumen of the first tubular member; and A kit comprising: c) a first guide wire; d) a second guide wire; e) a first balloon catheter; f) a second balloon catheter.