US20050273150A1 - Stent introducer system - Google Patents

Stent introducer system Download PDF

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Publication number
US20050273150A1
US20050273150A1 US11/095,208 US9520805A US2005273150A1 US 20050273150 A1 US20050273150 A1 US 20050273150A1 US 9520805 A US9520805 A US 9520805A US 2005273150 A1 US2005273150 A1 US 2005273150A1
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United States
Prior art keywords
introducer
stent
wire guide
catheter
delivery system
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Abandoned
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US11/095,208
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English (en)
Inventor
Douglas Howell
William Gibbons
Matthew Carter
Victor Clark
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Cook Endoscopy
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Individual
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Priority to US11/095,208 priority Critical patent/US20050273150A1/en
Assigned to WILSON-COOK MEDICAL INC. reassignment WILSON-COOK MEDICAL INC. ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: CLARK, JR., MR. VICTOR D., CARTER, MR. MATTHEW P., GIBBONS, MR. WILLIAM S.
Publication of US20050273150A1 publication Critical patent/US20050273150A1/en
Assigned to WILSON-COOK MEDICAL INC. reassignment WILSON-COOK MEDICAL INC. ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: CLARK, JR., VICTOR D., HOWELL, DOUGLAS A., CARTER, MATTHEW P., GIBBONS, WILLIAM S.
Priority to US12/689,804 priority patent/US8029555B2/en
Abandoned legal-status Critical Current

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    • 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
    • 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
    • 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
    • A61F2/954—Instruments specially adapted for placement or removal of stents or stent-grafts for placing stents or stent-grafts in a bifurcation
    • 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
    • A61F2/962—Instruments specially adapted for placement or removal of stents or stent-grafts having an outer sleeve
    • A61F2/97—Instruments specially adapted for placement or removal of stents or stent-grafts having an outer sleeve the outer sleeve being splittable
    • 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
    • A61F2002/041—Bile ducts
    • 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
    • A61F2002/065—Y-shaped blood vessels
    • A61F2002/067—Y-shaped blood vessels modular
    • 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
    • A61F2250/0058—Additional features; Implant or prostheses properties not otherwise provided for
    • A61F2250/0071—Additional features; Implant or prostheses properties not otherwise provided for breakable or frangible

Definitions

  • This invention generally relates to medical devices, and more particularly to devices for delivering stents to a target anatomy.
  • FIG. 1 is a partial, cross-sectional view of a biliary system 2 showing the common bile duct 2 a , the left hepatic duct 2 b , the right hepatic duct 2 c , the gall bladder 2 d , the pancreas 2 e and the duodenum 2 f.
  • FIG. 2 illustrates a partial cross-sectional view of the biliary system 2 having strictures 3 within the common bile duct 2 a , the left hepatic duct 2 b and the right hepatic duct 2 c .
  • One method of establishing proper drainage through the diseased ducts is to prop open the ducts by placing stents, such as self-expanding biliary stents, within the diseased ducts. Because of the branched configuration of the duct anatomy it is often necessary to place two or more stents in an overlying or side-by-side configuration.
  • FIG. 3 illustrates the problems associated with the prior art method of placing stents in the common bile duct 2 a and the left and right hepatic ducts 2 b , 2 c . That is, placing stent 16 within the common bile duct 2 a and the left hepatic duct 2 b impedes subsequent access to the stricture in the right hepatic duct 2 c . This prevents placement of a stent in the right hepatic duct 2 c.
  • FIG. 3A illustrates one problem encountered in the prior art by placing two stents sequentially. That is, once the first stent is deployed, it impedes insertion of the second introducer 20 used to deploy the second stent.
  • An alternative to sequential deployment of the stents is simultaneous deployment. Simultaneous deployment, however, requires the side-by-side arrangement of two stent introducers within the working channel of an endoscope. Depending on the size of the stents to be placed and the limited size of the working channel of the endoscope, this option may be unworkable.
  • a stent delivery system having a first introducer used to deploy a first stent, and a sheath or catheter used to receive a second introducer, which in turn is used to deploy a second stent.
  • the first introducer and the catheter can be simultaneously deployed, for example, in a staggered configuration, through the working channel of an endoscope. Once the first stent is deployed, the catheter facilitates delivery of the second introducer to the target anatomy.
  • the catheter or sheath can be splittable.
  • wire guides are used to guide the placement of the first introducer, the catheter, and the second introducer.
  • the foregoing object is obtained by providing a method of placing at stents in the branches of a bifurcated target anatomy.
  • the method includes placing a first and a second wire guide in a working channel of an endoscope.
  • the first wire guide is inserted into the first branch lumen of the bifurcation.
  • the second wire guide is inserted into the second branch lumen of the bifurcation.
  • a first introducer and splittable catheter can then be advanced over the respective wire guides to the respective target anatomies. Once in place, the first stent can be deployed.
  • a second introducer can then be introduced over the second guide wire, through the splittable catheter and to the proper target anatomy. Once the second introducer is in place, the second stent can be deployed.
  • the method of the invention may further include any of the following steps: disposing the first introducer and the splittable catheter within the working channel of the endoscope such that the first introducer proximal portion is disposed adjacent to the splittable catheter and the first introducer distal portion is disposed distal to the splittable catheter while inside the working channel of the endoscope; deploying the first stent within the first branch lumen and the main lumen of the bifurcation and withdrawing the first introducer from the bifurcation; and/or splitting the splittable catheter and withdrawing the splittable catheter from the bifurcation.
  • FIG. 1 is a partial, cross-sectional view of a biliary system showing the common bile duct, the left hepatic duct, the right hepatic duct, the gall bladder, the pancreas and the duodenum.
  • FIG. 2 is a partial, cross-sectional view of the biliary system of FIG. 1 showing strictures within the common bile duct, the left hepatic duct and the right hepatic duct.
  • FIG. 3 is a partial, cross-sectional view of the biliary system of FIG. 2 illustrating a stent that has been placed in the common bile duct and the left hepatic duct.
  • FIG. 3A is a partial, cross-sectional view of the biliary system of FIG. 1 illustrating a first stent previously placed by a first introducer in the right hepatic duct and the common bile duct that obscures the access of a second introducer attempting to place a second stent in the left hepatic duct and common bile duct.
  • FIG. 4 is a partial, cross-sectional view of the biliary system of FIG. 2 illustrating the placement of first and second stents in the left and right hepatic ducts, respectively, and the common bile duct according to a preferred method of the present invention.
  • FIG. 5 is a partial, cross-sectional view of a preferred embodiment of the stent delivery system of the present invention illustrating a first introducer placed within the right hepatic duct and the common bile duct and a splittable catheter placed in the right hepatic duct and the common bile duct.
  • FIG. 6 is a partial, cross-sectional view of the preferred embodiment of the stent delivery system of FIG. 5 illustrating a first stent deployed in the right hepatic duct and common bile duct after the first introducer has been removed and the splittable catheter placed in the right hepatic duct and the common bile duct.
  • FIG. 7 is a partial, cross-sectional view of the preferred embodiment of the stent delivery system of FIG. 6 illustrating a first stent deployed in the right hepatic duct and common bile duct and the splittable catheter shielding a second introducer as the second introducer is advanced over a second wire guide into the common bile duct and the left hepatic duct.
  • FIG. 8 is a cross-sectional, end view of the stent delivery system of the present invention showing the first introducer and the splittable catheter within the working channel of an endoscope.
  • FIG. 9 is a partial, cross sectional, side-view of a preferred embodiment of the stent delivery system of the present invention showing the first introducer and the splittable catheter within the working channel of an endoscope.
  • FIG. 10 is a cross-sectional view of an embodiment of the first introducer of the stent delivery system of the present invention.
  • FIG. 11 is a partial, cross-sectional view of a distal portion of the first introducer of FIG. 5 .
  • FIG. 12 is a partial, cross-sectional view of an alternate embodiment of the distal portion of the first introducer of FIG. 5 .
  • FIG. 13 is a partial, cross-sectional view of the distal portion of the first introducer of FIG. 5 showing the wire guide and wire guide lumen.
  • FIG. 14 is a partial, cross-sectional view of the distal portion of the first introducer of FIG. 5 showing an alternate embodiment of the wire guide and the wire guide lumen.
  • FIG. 15 is a partial, cross-sectional view of the distal portion of the first introducer of FIG. 5 showing an alternate embodiment of the wire guide and the wire guide lumen.
  • FIGS. 1-2 and 4 a bifurcation having a main lumen, a first branch lumen and a second branch lumen.
  • these figures illustrate a bifurcation in the biliary system, wherein the main lumen comprises the common bile duct 2 a and the first and second branch lumens comprise the left and right hepatic ducts 2 b , 2 c respectively.
  • FIG. 1 shows a normal, or healthy, biliary system without strictures.
  • FIG. 2 shows the biliary system with strictures 3 residing in the main lumen and in both branch lumens of the bifurcation.
  • FIG. 4 shows a pair of stents placed in the left and right hepatic ducts 2 b , 2 c , respectively, and the common bile duct 2 a according to a method of the present invention.
  • the stent delivery system includes a first and second introducers configured to deliver two stents to a target anatomy, as well as a catheter used to facilitate delivery of the second introducer to a target anatomy.
  • the first introducer 10 and the splittable catheter 50 are adapted to be disposed within the working channel 8 a of an endoscope 8 as shown in FIGS. 5, 8 and 9 .
  • the splittable catheter 50 includes an interior passageway through which the second introducer can be advanced.
  • the splittable catheter 50 is an elongate, flexible tube adapted to allow the second introducer 20 to advance unobstructed into the target anatomy.
  • the splittable catheter 50 can be formed from a frangible material, for example, a material that readily tears in a longitudinal direction along the length of the sheath.
  • a non-limiting example of a splittable material is a molecularly oriented (non-isotropic) polytetrafluoroethylene (PTFE) such as that used in the PEEL-AWAYTM Sheath (Cook Incorporated, Bloomington, Ind.).
  • splittable catheter 50 can be formed from any suitable material known in the art including, but not limited to, PTFE, polyamide, polyurethane, polyethylene and nylon including multi-layer or single layer structures.
  • the splittable catheter 50 can also be provided with a groove, pre-score, a weakened area or a pre-slit end to facilitate splitting.
  • Splittable catheter 50 can ranges in size from about 5 Fr. to about 9 Fr. These sizes are provided for illustrative purposes only and are not intended to be construed as a limitation of the present invention. As one of ordinary skill in the art would appreciate in view of the present disclosure, the size of the splittable catheter 50 is related to the size of the second introducer 20 that is advanced through it, which in turn is related to the size of the second stent 26 in its compressed or unexpanded configuration. Thus, splittable catheters smaller than about 5 Fr. that may become available in the future are contemplated as being within the scope of the claims of the invention.
  • any introducer capable of introducing and deploying stents is contemplated.
  • Non-limiting examples include biliary stent deployment delivery systems as well as the introducers described in co-pending provisional application Ser. No. 10/728,589 (Attorney docket number 10000/218), which is incorporated by reference in its entirety.
  • the introducers can be of the same or different type and size.
  • FIGS. 10-15 illustrate several, non-limiting, exemplary embodiments of introducer 10 .
  • introducer 10 has a proximal end and a distal end having inner and outer coaxial tubes.
  • the outer coaxial tube forms an outer sheath or catheter 11 .
  • the inner coaxial tube forms a shaft 13 .
  • Shaft 13 has a proximal end 13 a , a distal end 13 b and a stent retaining area 15 .
  • shaft 13 may include a pusher band 17 attached to the stent retaining area 15 , a distal tip 18 attached to the shaft distal end 13 b and a wire guide lumen 19 .
  • Shaft 13 can be made from any suitable material known in the art including, but not limited to, polyethylene ether ketone (PEEK), polytetra-fluoroethylene (PTFE), polyamide, polyurethane, polyethylene and nylon, including multi-layer or single layer structures and may also include reinforcement wires, braid wires, coils and or filaments.
  • shaft 13 comprises a proximal portion made of a relatively rigid material such as stainless steel or any other suitable material known in the art.
  • Stent retaining area 15 is preferably located on a distal portion of the shaft 13 .
  • the stent retaining area 15 retains a stent 16 to be deployed in the bifurcation.
  • stent 16 is a self-expanding stent.
  • Pusher band 17 helps to prevent the stent from proximally migrating as the outer catheter 11 is withdrawn proximally to deploy the stent.
  • the pusher band 17 is located proximal to the stent 16 such that the proximal end of the stent 16 abuts the pusher band 17 as shown in FIGS. 10-15 .
  • Distal tip 18 helps prevent fluids from entering the outer catheter 11 as the introducer 10 is navigated through the body lumens. As shown in FIGS. 10-15 , distal tip 18 has a proximal end 18 a and a distal end 18 b .
  • the distal tip proximal end 18 a has a diameter that is less than the diameter of the distal outer catheter distal end 14 b and is received therein.
  • the distal tip 18 tapers to a smaller diameter towards its distal end 18 b as shown in FIG. 12 .
  • Distal tip 18 can be made from any suitable material known in the art including, but not limited to, PEEK, PTFE, polyamide, polyurethane, polyethylene and nylon, including multi-layer or single layer structures.
  • wire guide lumen 19 extends through the shaft 13 , from the shaft distal end 13 b to the shaft proximal end 13 a .
  • the shaft proximal end 13 a optionally includes a luer-lock fitting 31 for releaseably fixing a wire guide 32 relative to shaft 13 as shown in FIG. 10 .
  • the stent delivery system 1 of the present invention includes an over-the-wire type wire guide. Such wire guides are known in the art.
  • the wire guide lumen 19 may extend through the shaft 13 from the shaft distal end 13 b to the shaft proximal end 13 a but the wire guide 32 exits through an aperture positioned along the length of the introducer 10 .
  • the wire guide 32 extends through a portion of the distal tip 18 and exits through an aperture 30 positioned along the length of the distal tip 18 .
  • the wire guide 32 extends through the distal tip 18 and exits the introducer 10 without passing through stent 16 .
  • wire guide 32 may extend proximally through distal tip 18 for a distance of about 1 cm.
  • the wire guide lumen 19 extends through the length of the shaft 13 but the wire guide 32 extends through a portion of the shaft 13 and exits through an aperture 30 positioned along the length of outer catheter 11 .
  • wire guide 32 extends through the distal tip 18 , through a portion of the shaft 13 and passes through stent 16 before exiting introducer 10 .
  • wire guide 32 may extend through the distal tip 18 and through the stent retaining area 15 for a distance of about 20 cm.
  • the wire guide lumen 19 may extend through a portion of shaft 13 and may exit through an aperture 30 positioned along the length of the introducer 10 . Any number of apertures 30 positioned at any location along the length of the introducer 10 is contemplated.
  • the wire guide lumen 19 may also comprise a channel or split.
  • Aperture 30 provides the stent delivery system of the present invention with rapid-exchange capabilities.
  • the delivery system can be removed from a wire guide 32 having a length substantially shorter than the length necessary if the wire guide 32 were extended through the entire length of the wire guide lumen 19 .
  • the sheath or outer catheter 11 has a proximal end 11 a and a distal end 11 b .
  • at least the distal portion of outer catheter 11 is made of any optically clear or imageable material. This allows the stent 16 mounted on the stent retaining area 15 of the shaft 13 to be viewed.
  • the outer catheter 11 further includes a proximal outer catheter 12 having proximal and distal ends, 12 a and 12 b , respectively, and a distal outer catheter 14 having proximal and distal ends, 14 a and 14 b , respectively.
  • the distal end 12 b of the proximal outer catheter 12 is attached to the proximal end 14 a of the distal outer catheter 14 to form outer catheter 11 .
  • the distal end 12 b of proximal outer catheter 12 can be attached to the proximal end 14 a of distal outer catheter 14 by any method known in the art including, but not limited to, heat fusing, adhesive bonding, chemical bonding or mechanical fitting.
  • the proximal outer catheter 12 , and the distal outer catheter 14 can be formed from of a single catheter or sheath.
  • the introducer proximal outer diameter is between about 5 Fr. and about 6 Fr.
  • the first introducer distal outer diameter is between about 6 Fr. and about 6.5 Fr. This allows placement of a stent having a compressed diameter between about 0.077 inches and about 0.78 inches.
  • These sizes are provided for illustrative purposes only and are not intended to be construed as a limitation of the present invention.
  • the size of the introducer required to place a stent is related to the size of the stent to be placed, and more particularly, to the size of the compressed configuration of the stent.
  • introducers having distal outer diameters less than about 6 Fr. used to place stents having compressed configurations less than about 0.078 inches that may become available in the future are contemplated as being within the scope of the present disclosure.
  • the first introducer 10 and the splittable catheter 50 are sized to be disposed next to each other in the working channel 8 a of an endoscope 8 . More particularly, the sum of the first introducer 10 outer diameter, i.e. either the proximal outer diameter or the distal outer diameter, and the splittable catheter outer diameter is less than the inner diameter of the working channel 8 a of the endoscope 8 .
  • the first introducer 10 and the splittable catheter 50 are disposed next to each other in a staggered configuration within the working channel 8 a of an endoscope 8 . That is, the introducer has an increased diameter portion (the stent retaining area) and a decreased diameter portion (the proximal outer catheter).
  • the introducer and catheter When the introducer and catheter are positioned in an endoscope adjacent to one another and staggered the respective increased and decreased diameter portions are nested together. As can be seen in FIG. 9 , the sum of the first introducer proximal outer diameter and the splittable catheter 50 is less than the inner diameter of the working channel 8 a of the endoscope 8 .
  • the first introducer 10 and the splittable catheter 50 are sized to also accommodate at least one wire guide 32 or 42 within the working channel 8 a of the endoscope 8 .
  • the sum of the first introducer proximal outer diameter, the splittable catheter outer diameter and at least one of the first and second wire guides 32 , 42 is less than the inner diameter of the working channel 8 a of the endoscope 8 .
  • the stent delivery system 1 of the present invention is used to place first and second stents 16 , 26 into a bifurcation having strictures 3 in the main lumen 2 a and the first and second branch lumens 2 b , 2 c as follows.
  • a distal end of a first wire guide is advanced into the first branch lumen of the bifurcation.
  • a distal end of a second wire guide is then advanced into the second branch lumen of the bifurcation.
  • the first introducer 10 and the splittable catheter 50 are advanced over the wire guide into the working channel 8 a of the endoscope 8 .
  • the first introducer 10 is positioned within the first branch of the bifurcation and the splittable catheter 50 is positioned within the second branch lumen of the bifurcation, as shown in FIG. 5 .
  • the first introducer 10 and splittable catheter 50 may be positioned sequentially or simultaneously.
  • the first introducer 10 is positioned such that the first stent 16 is at least partially aligned within any occlusion of narrowing of the first branch of the bifurcation. Once aligned, the first stent is deployed within the first branch of the bifurcation and the first introducer is withdrawn as shown in FIG. 6 .
  • FIG. 7 shows that the splittable catheter 50 acts as a shield to protect the second introducer 20 from being snagged, or otherwise blocked, by the deployed first stent 16 .
  • FIG. 7 also shows the splittable catheter 50 splitting, or peeling away, as the second introducer 20 is advanced through it and into the second branch lumen 26 .

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  • Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Transplantation (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Vascular Medicine (AREA)
  • Cardiology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Media Introduction/Drainage Providing Device (AREA)
  • Prostheses (AREA)
  • Radiation-Therapy Devices (AREA)
US11/095,208 2004-03-31 2005-03-31 Stent introducer system Abandoned US20050273150A1 (en)

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US11/095,208 US20050273150A1 (en) 2004-03-31 2005-03-31 Stent introducer system
US12/689,804 US8029555B2 (en) 2004-03-31 2010-01-19 Stent introducer system

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US11/095,208 US20050273150A1 (en) 2004-03-31 2005-03-31 Stent introducer system

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EP (1) EP1732470B1 (enExample)
JP (1) JP4714736B2 (enExample)
AT (1) ATE468830T1 (enExample)
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Cited By (10)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20090048654A1 (en) * 2007-08-15 2009-02-19 Wilson-Cook Medical Inc. Deployment System for Soft Stents
US8034100B2 (en) 1999-03-11 2011-10-11 Endologix, Inc. Graft deployment system
US8167925B2 (en) 1999-03-11 2012-05-01 Endologix, Inc. Single puncture bifurcation graft deployment system
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WO2005096994B1 (en) 2005-12-15
US20100121426A1 (en) 2010-05-13
EP1732470B1 (en) 2010-05-26
US8029555B2 (en) 2011-10-04
ATE468830T1 (de) 2010-06-15
JP2007531599A (ja) 2007-11-08
JP4714736B2 (ja) 2011-06-29
WO2005096994A1 (en) 2005-10-20
EP1732470A1 (en) 2006-12-20
DE602005021473D1 (de) 2010-07-08

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