US20140046429A1 - Stent delivery systems and associated methods - Google Patents
Stent delivery systems and associated methods Download PDFInfo
- Publication number
- US20140046429A1 US20140046429A1 US13/964,015 US201313964015A US2014046429A1 US 20140046429 A1 US20140046429 A1 US 20140046429A1 US 201313964015 A US201313964015 A US 201313964015A US 2014046429 A1 US2014046429 A1 US 2014046429A1
- Authority
- US
- United States
- Prior art keywords
- stent
- deploying
- lead screw
- target area
- end portion
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Abandoned
Links
Images
Classifications
-
- 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
- A61F2/966—Instruments specially adapted for placement or removal of stents or stent-grafts having an outer sleeve with relative longitudinal movement between outer sleeve and prosthesis, e.g. using a push rod
-
- 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
- A61F2/9517—Instruments specially adapted for placement or removal of stents or stent-grafts handle assemblies therefor
-
- 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
Definitions
- the present technology relates to treatment of abdominal aortic aneurysms. More particularly, the present technology relates to handle assemblies for stent graft delivery systems and associated systems and methods.
- An aneurysm is a dilation of a blood vessel of at least 1.5 times above its normal diameter.
- the dilated vessel forms a bulge known as an aneurysmal sac that can weaken vessel walls and eventually rupture.
- Aneurysms are most common in the arteries at the base of the brain (i.e., the Circle of Willis) and in the largest artery in the human body, the aorta.
- the abdominal aorta spanning from the diaphragm to the aortoiliac bifurcation, is the most common site for aortic aneurysms.
- Such abdominal aortic aneurysms typically occur between the renal and iliac arteries, and are presently one of the leading causes of death in the United States.
- AAAs The two primary treatments for AAAs are open surgical repair and endovascular aneurysm repair (EVAR).
- Surgical repair typically includes opening the dilated portion of the aorta, inserting a synthetic tube, and closing the aneurysmal sac around the tube.
- EVAR endovascular aneurysm repair
- Such AAA surgical repairs are highly invasive, and are therefore associated with significant levels of morbidity and operative mortality.
- surgical repair is not a viable option for many patients due to their physical conditions.
- EVAR vascular endovascular aneurysm repair
- EVAR typically includes inserting a delivery catheter into the femoral artery, guiding the catheter to the site of the aneurysm via X-ray visualization, and delivering a synthetic stent graft to the AAA via the catheter.
- the stent graft reinforces the weakened section of the aorta to prevent rupture of the aneurysm, and directs the flow of blood through the stent graft away from the aneurysmal region. Accordingly, the stent graft causes blood flow to bypass the aneurysm and allows the aneurysm to shrink over time.
- stent and stent graft systems for cardiovascular applications utilize self-expanding designs that expand and contract predominantly in the radial dimension.
- other system include braided stent grafts that are delivered in a radially compressed, elongated state. Upon delivery from a delivery catheter, the stent graft will radially expand and elastically shorten into its free state. In other words, the effective length of the stent graft changes as its diameter is forced smaller or larger. For example, a stent graft having a shallower, denser helix angle will result in a longer constrained length. Once the stent graft is removed from a constraining catheter, it can elastically return to its natural, free length.
- Delivering a stent graft to an artery requires accurate and precise positioning of the stent graft relative to a target location in the destination artery.
- a misplaced stent graft can block flow to a branching artery.
- Some stent graft delivery systems utilize one or more markers (e.g., radiopaque markers) to establish the alignment of the stent graft relative to the artery wall.
- the location of the radiopaque markers on the stent graft can move relative to an initial marker position because of the change in the stent graft's effective length upon deployment, as described above.
- the stent graft (e.g., its proximal or distal edge) may miss the target point in the artery. Therefore, there are numerous challenges associated with the accurate positioning of stent grafts that change dimensions in both the radial and longitudinal directions.
- FIG. 1A is an isometric view of a stent graft delivery system configured in accordance with an embodiment of the technology.
- FIGS. 1B and 1C are functional schematic diagrams of a portion of a handle assembly system configured in accordance with embodiments of the technology.
- FIG. 2A is an isometric view of a handle assembly configured in accordance with an embodiment of the technology.
- FIGS. 2B and 2C are side views of a delivery catheter of a stent graft delivery system configured in accordance with an embodiment of the technology.
- FIGS. 2D and 2E are side views of collets of a stent graft delivery system configured in accordance with an embodiment of the technology.
- FIGS. 3A-3C are side views of a delivery catheter of a stent graft delivery system configured in accordance with an embodiment of the technology.
- FIGS. 4A-4E are front and side views of collets of a stent graft delivery system configured in accordance with various embodiments of the technology.
- FIGS. 5A and 5B are partial side views of a handle assembly and a housing, respectively, configured in accordance with various embodiments of the technology.
- FIG. 6A is a partial cut-away view of a handle assembly configured in accordance with an embodiment of the technology.
- FIGS. 6B-6D are enlarged partial cut-away views of portions of the handle assembly of FIG. 6A .
- FIG. 6E is an isometric view of a portion of the handle assembly of FIG. 6A .
- FIG. 7 is an enlarged partial cut-away view of a distal portion of the handle assembly configured in accordance with an embodiment of the technology.
- FIG. 8A is an isometric view of a handle assembly configured in accordance with another embodiment of the technology.
- FIG. 8B is an enlarged, partially translucent isometric view of a portion of the handle assembly of FIG. 8A .
- FIG. 9 is a partial cut-away isometric view of a handle assembly configured in accordance with another embodiment of the technology.
- FIGS. 10A and 10B are side and partial cut-away views, respectively, of a handle assembly configured in accordance with another embodiment of the technology.
- FIG. 11A is an isometric view of a stent graft delivery system configured in accordance with another embodiment of the technology.
- FIGS. 11B and 11C are side views of a delivery catheter of the stent graft delivery system of FIG. 11A configured in accordance with an embodiment of the technology.
- FIG. 11D is a side view of a collet of the a stent graft delivery system of FIG. 11A configured in accordance with an embodiment of the technology.
- FIG. 12A is a partial cut-away view of a handle assembly configured in accordance with an embodiment of the technology.
- FIGS. 12B-12D are enlarged partial cut-away views of portions of the handle assembly of FIG. 12A .
- FIG. 13 is a partially translucent isometric view of a portion of a handle assembly configured in accordance with another embodiment of the technology.
- FIG. 14 is a partially translucent isometric view of a portion of a handle assembly configured in accordance with another embodiment of the technology.
- FIG. 15A is a partial isometric view of a portion of a handle assembly configured in accordance with an embodiment of the technology.
- FIG. 15B is an enlarged view of a portion of the handle assembly of FIG. 15A .
- FIG. 15C is a partially translucent side view of a portion of the handle assembly of FIG. 15A .
- FIGS. 16A and 16B are partially schematic representations of a method of stent graft delivery in accordance with an embodiment of the technology.
- FIG. 17 is a partially schematic representation of a method of stent graft delivery in accordance with an embodiment of the technology.
- FIGS. 18A-18E illustrate a stent delivery method in accordance with an embodiment of the technology.
- FIGS. 19A-19C illustrate a stent delivery method in accordance with another embodiment of the technology.
- the present technology is directed toward handle assemblies for stent delivery systems and associated systems and methods. Certain specific details are set forth in the following description and in FIGS. 1A-19C to provide a thorough understanding of various embodiments of the technology. For example, many embodiments are described below with respect to the delivery of stent grafts that at least partially repair AAAs. In other applications and other embodiments, however, the technology can be used to repair aneurysms in other portions of the vasculature. Furthermore, the technology can be used to deliver a stent for any suitable purpose in any suitable environment.
- distal and proximal can reference a relative position of the portions of an implantable stent graft device and/or a delivery device with reference to an operator. Proximal refers to a position closer to the operator of the device, and distal refers to a position that is more distant from the operator of the device. Also, for purposes of this disclosure, the term “helix angle” refers to an angle between any helix and a longitudinal axis of the stent graft.
- various embodiments of a stent delivery system 100 can include a delivery catheter 120 having a shaft or tubular enclosure 124 on a distal end portion of the catheter 120 , a braided stent 110 ( FIGS. 1B and 1C ) constrained within the tubular enclosure 124 , and a handle assembly 150 at a proximal end portion of the delivery catheter 120 .
- Various embodiments of the technology may be used to deliver the braided 110 stent to a target area within a body lumen of a human.
- one embodiment of the stent delivery system 100 can be configured to deploy a stent at a target location in an aorta such that at least a portion of the stent is superior to an aortic aneurysm.
- another embodiment of the stent delivery system 100 can be configured to deploy a stent at a target location in an iliac artery such that at least a portion of the stent is inferior to an aortic aneurysm.
- Further embodiments of the technology may be used to deliver a stent to any suitable target area.
- the delivery catheter 120 of various embodiments can include a distal end portion insertable into a body lumen within a human and navigable toward a target area, and nested components configured to mechanically communicate actions of the handle assembly 150 to distal end portion of the delivery catheter 120 .
- the stent 110 FIGS. 1B and 1C ) can be constrained in a radially compressed state at the distal end portion of the delivery catheter 120 .
- the delivery catheter 120 has a diameter of approximately 14 Fr, but in other embodiments the delivery catheter 120 can have a greater diameter or a smaller diameter, such as 10 Fr or 8 Fr.
- FIGS. 2A-2E illustrate an embodiment of a stent delivery system 200 configured in accordance with another embodiment of the technology
- FIGS. 3A-3C illustrate portions of a delivery catheter 220 of the stent delivery system 200 of FIGS. 2A-2C
- the stent delivery system 200 can include the delivery catheter 220 and handle assembly 250 operably coupled to the delivery catheter 220
- the distal end portion of delivery catheter 220 includes a distal top cap 222 and an outer sheath 224 that engage a stent 210 .
- the distal top cap 222 covers and constrains at least a distal end portion 210 d of the stent 210 in a radially compressed configuration
- the outer sheath 224 covers and constrains at least a proximal end portion 210 p of the stent 210 in a radially compressed configuration.
- the top cap 222 and outer sheath 224 can overlap or meet edge-to-edge so as to entirely cover the stent 210 , though in other embodiments the top cap 222 and outer sheath 224 can leave a medial portion of the stent 210 uncovered.
- the top cap 222 can have a tapered distal end to help navigate the catheter through a patient's vasculature, and/or a radiused proximal edge that may reduce snagging or catching on vasculature or other features during catheter retraction after stent deployment.
- FIGS. 11A-12D show an embodiment of a delivery system 400 configured in accordance with another embodiment of the technology. Similar to the stent delivery system 200 of FIGS. 2A-2E , the stent delivery system 400 of FIGS. 11A-12D can include a delivery catheter 420 and handle assembly 450 operably coupled to the delivery catheter 420 . As shown in FIGS. 11B and 11C , the distal end portion of the delivery catheter 420 can include a distal top cap 424 having a tubular enclosure that covers and constrains the entirety of the stent 410 in a radially compressed configuration. Removing the top cap 424 in a distal direction can expose the stent 410 . Similar to the top cap 222 shown in FIGS. 2B and 2C , the top cap 424 can have a tapered distal end and/or radiused proximal edge.
- delivery catheters can have distal end portions that include an outer sheath that covers and constrains the entirety of the stent in a radially compressed configuration such that retraction of the outer sheath in a proximal direction exposes the stent.
- the top cap 222 , 424 and/or the outer sheath can include radiopaque markers that provide visual aids for device positioning during deployment procedures. Such radiopaque markers can be helical, circumferential rings, and/or have any other suitable form.
- the top cap 222 , 424 and/or the outer sheath can include structural reinforcements, such as filaments, to discourage deformation in tension or compression.
- axially-oriented filaments can be interwoven or otherwise coupled to the top cap 222 , 424 or outer sheath such that the top cap 222 , 424 or outer sheath is stretch-resistant and facilitates smooth, predictable actuation by the various nested components described below.
- the top cap 222 , 424 and/or outer sheath can include other reinforcements to increase column strength and discourage buckling during actuation by the various nested components.
- the stent 210 can be disposed at the distal end portion of the delivery catheter 220 .
- the stent 210 can be a bare stent or a stent graft, such as those described in U.S. Application Patent Publication No. 2011/0130824, which is incorporated herein by reference in its entirety.
- the stent 210 can be any suitable braided stent or other self-expanding stent.
- the stent 210 can be constrained in a radially compressed configuration by the top cap 222 and/or an outer sheath. Additionally, as shown in FIG.
- the stent prior to stent deployment, can be axially constrained at the distal end portion of the delivery catheter 220 with one or more collets 226 , 228 coupled to one or more nested components of the delivery catheter 220 .
- FIGS. 4A-4E are front and side views of various collets 226 , 228 that are configured to couple stents to the distal end portion of the delivery catheter 220 ( FIG. 2C ).
- the collets 226 and 228 can each include a fluted portion with circumferentially distributed prongs 227 , each of which engages an opening on a stent and constrains the longitudinal position of the stent at the point of engagement.
- Each prong 227 can have a radius of curvature that matches that of the stent it is configured to engage and a height that exceeds the height of the stent wire by a suitable amount so as to help ensure engagement with the stent.
- the prongs 227 may have a height about 1.5 times the height of the stent wire. In other embodiments, the prongs 227 may have other suitable heights.
- the number, arrangement, and particular prong profiles can be suitably tailored to the specific application.
- the collets 226 and 228 can include an angled tip, a 5-point angled tip, a rounded tip that reduces or eliminates friction or undesirable catching on the stent wire, and/or a spring 229 ( FIG. 4E ) that assists in launching the stent wire into radial expansion during stent deployment.
- Delivery systems in accordance with the present technology can include a trailing or proximal collet 226 ( FIGS. 4D and 4E ) coupled to a proximal end portion of a stent, a leading or distal collet 228 ( FIGS. 4A-4C ) coupled to a distal end portion of the stent, or both the trailing collet 226 and the leading collet 228 .
- individual collets can be coupled to other suitable portions of a stent (e.g., a medial portion of a stent).
- one or more end portions of a stent can be coupled to the distal end portion of the delivery catheter 420 with a smooth, prongless docking tip 426 .
- Nested components along the delivery catheters 220 and 420 described above can be configured to mechanically control aspects of the distal end portion of the delivery catheter.
- each of the nested components can be configured to longitudinally move independently of the other nested components, whereas in other embodiments two or more nested components can temporarily or permanently be locked together to permit movement in tandem.
- At least portions of the nested components outside of a handle assembly e.g., the handle assemblies 250 and 450
- the nested components can include a plurality of tubes and/or wires that are configured to push and/or pull various components of the distal end portion of the delivery catheter.
- the components of the delivery catheters 220 and 420 are described herein as “nested”, in other embodiments the delivery catheters 220 and 420 can include similar operative components arranged laterally offset from one another.
- FIG. 2C shows an embodiment of the delivery catheter 220 in which the nested components include a tip tube 230 , an inner shaft 232 , and a dilator 236 , although in other embodiments the delivery catheter 220 can include any suitable number of tubes and/or shafts.
- the nested components can further include one or more stiffeners 234 disposed within and/or around other nested components.
- the stiffener 234 can, for example, axially reinforce a portion of a pushing component (e.g., the inner shaft 232 ) to increase the column strength of the pushing component.
- the stiffener 234 can be made of stainless steel or any other suitably rigid material. In the embodiment shown in FIGS.
- the tip tube 230 is disposed within the inner shaft 232 , and the inner shaft 232 is disposed within the dilator 236 , with the stiffener 234 ( FIG. 6A ) surrounding and reinforcing portions of the tip tube 230 and the inner shaft 232 within the handle assembly 250 .
- the tip tube 230 is operatively connected to the top cap 222 such that proximal and distal movement of the tip tube 230 corresponds to longitudinal movement of the top cap 222 .
- sufficient distal movement of the tip tube 230 can cause the top cap 222 to move distally enough to release the distal end portion 210 d of the stent 210 , thereby allowing the distal end portion 210 d of the stent 210 to self-expand.
- the tip tube 230 can be made of stainless steel, and in other embodiments the tip tube 230 can additionally or alternatively include any other suitable materials.
- the tube 230 can include suitable structural reinforcing features, such as a stainless steel braid.
- the inner shaft 232 is operatively connected to the leading collet 228 engaged with the distal end portion 210 d of the stent 210 such that proximal and distal movement of the inner shaft 232 corresponds to longitudinal movement of the leading collet 228 and distal end portion 210 d of the stent 210 .
- the inner shaft 232 can be in mechanical communication with the distal end portion 210 d of the stent 210 in other suitable manners.
- the inner shaft 232 can permit, within its lumen, telescopic movement of the tip tube 230 , thereby allowing longitudinal movement of the top cap 222 relative to the leading collet 228 .
- the inner shaft 232 can be a tube made of polyimide and/or other suitable materials.
- the dilator 236 is operatively connected to the trailing collet 226 , which is in turn engaged with the proximal end portion 210 p of the stent 210 such that proximal and distal movement of the dilator 236 corresponds to longitudinal movement of the trailing collet 226 and the proximal end portion 210 p of the stent 210 .
- the dilator 236 can permit, within its lumen, telescopic movement of the tip tube 230 and the inner shaft 232 .
- the outer sheath 224 can permit, within its lumen, the telescopic movement of the dilator 236 .
- the top cap 222 , the leading collet 228 , and the trailing collet 226 may move relative to one another corresponding to relative movement of the tip tube 230 , the inner shaft 232 , and the dilator 236 , respectively.
- the dilator 236 can be made from nylon and/or various other suitable materials.
- the nested components described above with respect to FIGS. 2C , 6 A, and 6 C can be used to deliver a stent to an aorta before an aneurysm. In other embodiments, the nested components can be used to deliver stents to other blood vessels, such as the iliac arteries.
- FIGS. 11A-11C show another embodiment of the delivery catheter 420 in which the nested components include a tip tube 430 , an inner shaft 432 , and a dilator 436 , although in other embodiments the delivery catheter 420 can include any suitable number of tubes and/or shafts.
- the nested components can additionally include one or more stiffeners (identified individually as a first stiffener 434 a and a second stiffener 434 b , and referred to collectively as stiffeners 434 ) disposed within and/or around other nested components. Similar to the embodiment of FIG. 6A , the stiffeners 434 can, for example, reinforce a pushing component for increased column strength of that pushing component.
- the stiffeners 434 can be made of stainless steel or any other suitably rigid material.
- a portion of the tip tube 430 is disposed within the inner shaft 432
- another portion of the tip tube 430 is disposed within the dilator 436 .
- the first and second stiffeners 434 a and 434 b can surround and reinforce another portion of the tip tube 430 within the handle assembly 450 .
- the nested components can be configured in any suitable arrangement. Furthermore, some or all of the nested components can be replaced or supplemented with wires or other suitable control mechanisms.
- the tip tube 430 is operatively connected to the top cap 424 such that the proximal and distal movement of the tip tube 430 corresponds to longitudinal movement of the top cap 424 .
- sufficient distal movement of the tip tube 430 can cause the top cap 424 to move distally enough to release the stent 410 , thereby allowing the stent to self-expand.
- the tip tube 430 can be made of stainless steel and/or other suitable materials.
- the tube 430 can include suitable structural reinforcing features, such as a stainless steel braid.
- the inner shaft 432 is operatively connected to the leading collet 428 , which is in turn engaged with the distal end portion 410 d of the stent 410 such that proximal and distal movement of the inner shaft 432 corresponds to longitudinal movement of the leading collet 428 and the distal end portion 410 d of the stent 410 .
- the inner shaft 432 can be in mechanical communication with the distal end portion 410 d of the stent 410 in any suitable manner.
- the inner shaft 432 can permit telescopic movement of the tip tube 430 .
- the inner shaft 432 can be a tube made of polyimide and/or other suitable materials.
- the dilator 436 can be coupled to a docking tip 426 , which engages with the proximal end portion 410 p of the stent 410 at the distal end portion of the delivery catheter 420 . Within its lumen, the dilator 436 can permit telescopic movement of the inner shaft 432 and the tip tube 430 .
- the dilator 436 is made of nylon and/or other suitable materials.
- the nested components described above with respect to FIGS. 11A-12B can be used to deliver a stent to an iliac artery after an aneurysm. In other embodiments, the nested components can be used to deliver stents to other blood vessels, such as the aorta.
- the nested components can be configured in any suitable arrangement. Additionally, other embodiments can include any suitable number of nested push/pull components. Furthermore, some or all of the nested components can be replaced or supplemented with wires or other suitable control mechanisms.
- handle assemblies can be used in conjunction with other aspects of the stent delivery systems 200 and 400 as described above, but can additionally or alternatively be used to deploy any suitable stent or stent graft constrained within a tubular enclosure of a delivery catheter in a radially compressed, elongated state.
- the handle assembly 150 of FIG. 1A can incorporate various mechanisms to effectuate the opposing displacement of an uncovering component 160 and a position compensating component 162 at a predetermined payout ratio, which deploys the stent 110 in a controlled manner.
- the uncovering component or element 160 can also configured to expose the stent 110 from the tubular enclosure 124 and allow the exposed portion of stent 110 to radially self-expand.
- the position compensating component 162 provides an axially compressive force on the stent 110 that counteracts the longitudinal displacement otherwise resulting from changing stent length as the stent 110 radially expands.
- the position compensating component 162 can actuate in a distal direction while the uncovering element 160 can actuate in a proximal direction.
- the positioning compensating component 162 can actuate in a proximal direction while the uncovering component 160 can actuate in a distal direction.
- the synchronized motion of the uncovering component 160 and the position compensating component 162 can control the axial position of the exposed portion of the stent 110 .
- the position of the deployed stent 110 can be maintained relative to a particular destination target location.
- it is desirable that at least one end of the stent 110 remain stationary during deployment in some alternative applications it might be desirable to modify the predetermined payout ratio so that the exposed portion of the stent 110 moves in a controlled manner at a predetermined rate.
- FIGS. 5A-12D illustrate various handle assemblies with lead screws configured in accordance with embodiments of the technology.
- a handle assembly for delivering a stent from a tubular enclosure can include a first lead screw 260 , a second lead screw 262 , and a housing 270 surrounding at least a portion of each of the first and second lead screws 260 and 262 .
- the first lead screw 260 has a lead thread of a first pitch and a first handedness (i.e., the lead screw has a right-handed or left-handed thread), and is coupled to the tubular enclosure.
- the second lead screw 262 has a lead thread of a second pitch and a second handedness different from the first handedness, and is coupled to the stent.
- the housing 270 surrounds at least a portion of each of the first and second lead screws 260 and 262 , and defines two housing threads, including a first housing thread 276 with the same pitch and handedness as the first lead screw 260 and a second housing thread 278 with the same pitch and handedness as the second lead screw 262 .
- the housing 270 and lead screws 260 , 262 can be configured to cooperate such that upon rotation of at least a portion of the housing around a longitudinal axis, the first housing thread 276 engages the first lead screw 260 and second housing thread 278 engages the second lead screw 262 .
- the engagements between the housing threads 276 , 278 and the lead screws 260 , 262 induce simultaneous translations of the first and second lead screws 260 and 262 in opposite directions along a longitudinal axis A-A ( FIG. 5A ) of the housing 270 , and the simultaneous translations deploy the stent from the tubular enclosure.
- translation of the first lead screw 260 can cause the tubular enclosure to translate to expose the stent and allow the exposed portion of the stent to radially self-expand.
- translation of the second lead screw 262 can apply an axially compressive force to the stent that substantially avoids or counterbalances longitudinal displacement of the end of the stent that is initially exposed.
- various embodiments of handle assemblies can include first and second lead screws that have different handedness such that their rotation in the same direction induces their movement in opposite directions.
- the first lead screw can have a right-handed thread
- the second lead screw can have a left-handed thread
- the first lead screw can have a left-handed thread
- the second lead screw can have a right-handed thread. Since the first and second lead screws have threads of opposite handedness, their concurrent rotation in the same direction will induce their translations in opposite directions.
- the threads of lead screws can be external threads (e.g., as shown in FIG. 5A ) or internal threads.
- the first and second lead screws in various embodiments of the handle assembly can have different thread pitches such that their concurrent rotation induces their movement at different rates of travel.
- the first lead screw 260 which is in mechanical communication with the tubular enclosure, can have a relatively coarse thread pitch
- the second lead screw 262 which is in mechanical communication with the proximal or distal end portion of the stent, can have a relatively fine thread pitch.
- the first lead screw 260 can have a relatively fine thread pitch
- the second lead screw 262 can have a relatively coarse thread pitch
- the first and second lead screws 260 and 262 can have substantially equal thread pitches.
- the ratio of thread pitches corresponds to a predetermined payout ratio of the first and second lead screws 260 and 262 and, in various embodiments, can correspond to the braid angle of the stent.
- the ratio of the coarse thread (e.g., on the first lead screw 260 ) to the fine thread (e.g., on the second lead screw 262 ) is approximately 1.5:1. Payout ratios ranging from about 1:1 to about 2:1 have also been shown to provide acceptable stent deployment. In other embodiments, the payout ratio of the first and second lead screws 260 and 262 can differ depending on the application.
- both the first and second lead screws 260 and 262 can have relatively fine thread pitches that may allow for precise deployment, since a fine lead screw axially translates less distance per rotation than a coarse lead screw would for the same rotation.
- the specific pitches and/or the ratio of the pitches can be selected to achieve a particular degree of mechanical advantage, a particular speed and precision of stent deployment, and/or a selected predetermined payout ratio.
- the first and second lead screws can have cross-sections that enable them to longitudinally overlap and slide adjacent to each other along the longitudinal axis of the handle.
- at least the threaded lengths of the lead screws 260 , 262 are “half” lead screws, each having an approximately semi-circular cross-section and arranged so that the lead screws 260 , 262 are concentric.
- the semi-circular cross-sections cooperate to define a lumen through which various push/pull tubes, wires, and/or other suitable mechanisms for stent deployment can travel and extend distally into the delivery catheter.
- the first and second lead screws 260 and 262 can have other complementary arcuate cross-sections, and/or other suitable cross-sectional shapes.
- the lead screws 260 and 262 can have an initial offset arrangement prior to stent deployment such that the first and second lead screws 260 and 262 have no longitudinal overlap within the housing 270 or overlap for only a portion of the length of the lead screws 260 , 262 .
- the lead screws 260 , 262 can translate relative to one another to increase their longitudinal overlap.
- the lead screws 260 , 262 in the initial offset arrangement have an initial overlap area of approximately five to nine centimeters (e.g., seven centimeters).
- the handle assembly can be configured such that rotation of the housing 270 during the course of stent deployment induces the first lead screw 260 (and movement of the tubular enclosure coupled thereto) to axially translate a distance of approximately 15 to 25 centimeters relative to its position in the initial offset arrangement. Additionally, the handle assembly can be configured such that rotation of the housing during the course of stent deployment induces the second lead screw 262 (and movement of the associated end of the stent) to axially translate a distance of approximately 5 to 15 centimeters.
- the second lead screw 262 which is in mechanical communication with an end of the stent, is configured to shorten the length of the stent (relative to the length of the stent in its elongated radially compressed configuration) by approximately 25% to 75% (e.g., approximately 50%).
- the degree of change in the stent length pre-deployment to post-deployment can differ depending on the specific application.
- rotation of the housing 270 during stent deployment can cause the first lead screw 262 to axially translate more than 25 centimeters or less than 15 centimeters from its initial position, and cause the second lead screw 262 to axially translate more than 15 centimeters or less than 5 centimeters from its initial position.
- first and second lead screws 260 and 262 can define additional mating features to facilitate mutual alignment.
- one lead screw e.g., the first lead screw 260
- the other lead screw e.g., the second lead screw 262
- the lead screws maintain longitudinal alignment with each other as the lead screws longitudinally translate past one another.
- one or both lead screws can include other suitable alignment features.
- the first and second lead screws 260 and 262 can be made of injection molded plastic of suitable column strength and overall torsional rigidity to bear axial loads and/or torsional loads during stent deployment.
- the lead screws 260 , 262 can additionally or alternatively include other suitable materials that are milled, turned, casted, and/or formed in any suitable manufacturing process to create the threads and other associated features of the lead screws 260 , 262 .
- the lead screws 260 , 262 can additionally or alternatively meet predetermined load requirements by including particular thread types (e.g., acme threads or other trapezoidal thread forms) and/or material reinforcements.
- the plastic material is of a formulation including a lubricant for low-friction thread engagement, such as LUBRILOY® D2000.
- suitable external lubricants can additionally or alternatively be applied to the lead screws 260 , 262 to help ensure smooth engagement of the threads.
- the housing can include a stationary portion and rotatable shaft portion.
- the housing 270 can include a first or rotatable shaft portion 252 a and a second or stationary portion 252 b coupled to one another and secured by a locking collar 254 .
- first shaft portion 252 a is referred to herein as the “rotatable shaft portion 252 a ” of the housing 270 and the second shaft portion 252 b is referred to as the “stationary shaft portion 252 b ”, it should be understood that in other embodiments either the first or second shaft portion 252 a or 252 b can be rotated in an absolute frame of reference, and/or rotated relative to the other shaft portion 252 a , 252 b .
- the rotatable shaft portion 252 a can define housing the first and second housing threads 276 and 278 that are configured to threadingly engage with corresponding threads on lead screws 260 and 262 .
- FIG. 11A illustrates another embodiment in which the housing 470 includes a first or rotatable shaft portion 452 a and a second or stationary portion 452 b that are coupled to one another and secured by a locking collar 454 .
- the housing 270 defines internal threads configured to engage with the externally threaded lead screws 260 , 262 ( FIG. 5A ). In other embodiments, the housing 270 can define external threads configured to engage with internally threaded lead screws.
- the stationary shaft portion 252 b (or another suitable part of housing 270 ) can include one or more keyway splines 279 ( FIG. 5B ), and/or any other suitable key mechanism. Each keyway spline 279 can engage a respective axial groove 269 ( FIG.
- the housing 270 can include shell pieces that mate and couple to one another to form the stationary shaft portion 252 b and the rotatable shaft portion 252 a .
- the shell pieces can define keys and/or other interlocking or alignment features to properly mate and form a volume or enclosure that is configured to house or otherwise contain the first and second lead screws 260 and 262 and/or other catheter components.
- the shell pieces can be snap fit together, attached by screws and/or other mechanical fasteners, and/or otherwise joined.
- the portions of the housing 270 can be composed of a suitable rigid plastic formed by injection molding.
- the housing 270 can additionally or alternatively include any other suitable materials and/or be formed by casting, turning, milling, and/or any other suitable manufacturing process.
- the housing 270 can be made of a lubricious plastic material and/or coated with external lubricant to facilitate smooth thread engagement with the lead screws 260 , 262 and relative rotation between the rotating and stationary shaft portions 252 a and 252 b of the housing 270 .
- FIGS. 6A-6E show an embodiment of the handle assembly 250 with the first and second lead screws 260 and 262 .
- the handle assembly 250 is configured to deploy, from the outer sheath 224 or other tubular enclosure, a distal end of the stent (not shown) before the proximal end of the stent during stent delivery.
- the handle assembly 250 enables accurate and precise positioning of the distal end of the stent. This functionality can be useful for applications where accurate and precise placement of the distal end of the stent is clinically necessary.
- this embodiment of handle assembly 250 can be used to deploy a stent graft in a known region of healthy aortic tissue that is superior to an aortic aneurysm but inferior to a renal artery. Precise superior positioning of the distal end of the stent is expected to increase (e.g., maximize) coverage of and sealing to healthy aortic neck tissue without blocking blood flow into the renal artery.
- the handle assembly 250 may be used in various other applications that require or benefit from accurate placement of a distal end of the stent (with respect to the handle operator) 1.
- the first lead screw 260 is directly or indirectly coupled to a tubular enclosure that can translate in a proximal direction to expose the stent.
- the first lead screw 260 can be coupled to outer sheath 224 of the delivery catheter such that translation of the first lead screw 260 actuates corresponding translation of the outer sheath 224 .
- the first lead screw 260 can be coupled to a distal coupler 242 , which is in turn coupled to the outer sheath 224 such that proximal and distal movement of the first lead screw 260 corresponds to proximal and distal movement of the outer sheath 224 .
- the coupling between the first lead screw 260 and the outer sheath 224 can include any suitable mechanical communication between the first lead screw 260 and a tubular enclosure housing a stent.
- the first lead screw 260 can be coupled directly to the tubular enclosure, coupled to a push or pull tube, a wire, and/or another suitable mechanism that is in turn coupled to the tubular enclosure.
- the first lead screw 260 can be coupled to the distal coupler 242 and/or other coupling epoxy, snap fit coupler designs, and/or any suitable mechanical fasteners.
- the coupling can additionally or alternatively include any suitable kind of coupling that effectuates movement of the tubular enclosure.
- the second lead screw 262 can be directly or indirectly coupled to a proximal end of the stent (not shown) such that translation of the second lead screw 262 actuates corresponding translation of the proximal end of the stent.
- the second lead screw 262 is configurable to be mechanical communication with a proximal coupler 240 that is coupled to dilator 236 , which is in turn coupled to the proximal end of the stent (e.g., as shown in FIG. 2C ).
- the second lead screw 262 can have a coupler engagement surface 264 in the same longitudinal path as the proximal coupler 240 such that when second lead screw 262 moves a sufficient distance in a distal direction, the coupler engagement surface 264 will abut the proximal coupler 240 . After this engagement occurs, distal movement of the second lead screw 262 will cause corresponding distal advancement of the proximal coupler 240 , the dilator 236 , and the proximal end of the stent.
- the coupling between the second lead screw 262 and the proximal end of the stent can include any suitable mechanical communication, such as those described above regarding the coupling between the first lead screw 260 and the outer sheath.
- the handle assembly 250 can further include a stent compressor in mechanical communication with a first portion (e.g., a distal portion) of the stent and independently movable relative to a second portion of the stent such that movement of the stent compressor is independent of the lead screws 260 , 262 and corresponds to axial compression and radial expansion of the stent.
- the stent compressor is defined by an axial compression slider 280 that is in mechanical communication with the distal end of the stent independent of the first and second lead screws 260 and 262 .
- the handle assembly 250 can include The axial compression slider 280 can be configured to axially compress the stent to facilitate positioning and longitudinal and rotational orientation.
- longitudinal proximal movement of the axial compression slider 280 can cause radial expansion and/or supplement self-expansion of the exposed portion of stent.
- a practitioner can partially deploy the stent in a “jackhammer” type motion to compress the braided stent, reposition the stent as necessary to best interface with the vasculature (e.g., achieve opposition between the vessel wall and stent graft to form or confirm a seal) and/or other adjacent device components, and then fully deploy the stent by allowing the stent to self-expand (or supplementing radial expansion with the axial compression slider 280 ) without constraint by the outer sheath, top cap, and/or distal collet. Furthermore, the practitioner can make adjustments by manipulating the axial compression slider 280 in a stent tensioning direction, thereby radially compressing the stent again to allow for repositioning of the stent.
- the axial compression slider 280 is configured to expand the stent from a first radius when in its radially compressed configuration to a deployment radius that is sufficiently large to form an at least substantially fluid-tight seal against the vessel in which the stent is being deployed.
- the axial compression slider 280 can be configured to expand from a smaller first radius to a larger deployment radius, where the deployment radius is between approximately three and five times the first radius (e.g., at least four times the first radius).
- the expansion ratio, or other relative change in cross-sectional stent dimension can depend on the specific application.
- the axial compression slider 280 ( FIG. 6E ) can engage a distal bearing assembly 282 , which is coupled to an inner shaft 232 by epoxy or any suitable fastening means.
- the inner shaft 232 can be in mechanical communication with the distal end of stent.
- Longitudinal movement of the compression slider 280 can correspond to longitudinal movement of the distal bearing assembly 282 .
- the distal bearing assembly 282 can ride within one or more slots 274 on opposite sides of the handle housing 270 ( FIG. 6A ), and this longitudinal movement of the bearing assembly 282 can correspond to longitudinal movement of the distal end of the stent.
- proximal movement of the slider 280 will proximally pull the distal end of the stent so that the stent is in an axially compressed, radially expanded state.
- distal movement of the slider 280 after some stent compression will distally extend the distal end of the stent so the stent is in a tensioned, radially constrained state, thereby allowing the practitioner to reposition the subsequently constrained stent relative to the vasculature.
- the axial compression slider 280 can include a locking tab 284 that selectively engages with one or more notches 272 ( FIGS.
- the slider 280 is free to longitudinally move and axially compress the stent.
- the longitudinal position of the slider 280 is set.
- the set of notches 272 can correspond to discrete degree of stent compression that the operator can use to gauge stent deployment.
- the handle assembly 250 can include any suitable locking mechanism for securing the longitudinal position of slider 280 .
- FIGS. 8A and 8B includes an axial compression slider 380 and/or other stent compressor that can be used to rotationally and longitudinally manipulate a compression coupler 384 , which is coupled to the inner shaft by epoxy and/or any suitable fastening means.
- longitudinal translation of the slider 380 corresponds, through mechanical communication, to longitudinal movement of the distal end portion of a stent for selective and reversible axial compression of the stent. As shown in FIG.
- the longitudinal position of the slider 380 can be locked by rotating the slider 380 so that the coupler 384 engages one of the plurality of slider lock notches 382 in the handle housing.
- the embodiment of FIG. 9 includes a compression lead screw 380 ′ coupled to the inner shaft by epoxy or any suitable fastening means. Rotation of the compression lead screw 380 ′ will result in its longitudinal translation and corresponding longitudinal motion of the inner shaft and distal end portion of the stent for selective and reversible axial compression of the stent.
- the handle assembly 250 embodiment can further include a top cap slider 290 ( FIG. 6E ) that is configured to distally move the top cap 222 .
- the top cap slider 290 can engage a proximal bearing assembly 292 ( FIG. 6C ), which is coupled to the tip tube 230 by epoxy or any suitable fastening means.
- the proximal bearing assembly 292 can ride along one or more slots 274 on opposite sides of the handle housing during its longitudinal movement. Because tip tube 230 is in mechanical communication with the top cap 222 , longitudinal movement of the top cap slider 290 corresponds to longitudinal movement of the top cap 222 .
- the top cap slider 290 can be selectively coupled to the axial compression slider 280 by means of a removable slider collar 294 .
- the slider collar 294 is coupled to both the compression slider 280 and the top cap slider 290 (e.g., with a snap fit or fasteners) the compression slider 280 and the top cap slider 290 can move in tandem.
- the compression slider 280 and the top cap slider 290 are movable independent of one another.
- the top cap slider 290 can also be locked directly to the compression slider 280 by a snap fit and/or other suitable fasteners (e.g., after the slider collar 294 is removed).
- An alternative embodiment of the top cap slider 290 is shown in FIGS. 10A and 10B , in which the top cap slider 290 is positioned on the proximal end portion of the housing and engages proximal bearing assembly 292 in a manner similar to that described above.
- the handle assembly 250 can include other mechanisms for moving a top cap.
- the embodiment of FIGS. 8A and 8B includes a tip release screw 390 . When turned, the tip release screw 390 can move distally and cause the top cap to move distally and release the distal end portion of the stent. The threads of the tip release screw 390 can prevent accidental deployment as the result of pushing axially on the head of the tip release screw 390 .
- the embodiment of FIG. 9 includes a tip release pusher 390 ′. When pushed in a distal direction, the tip release pusher 390 ′ moves distally and causes the top cap to move distally and release the distal end portion of the stent.
- additional locks and/or other safety mechanisms e.g., collars, mechanical fasteners, mechanical keys, etc.
- FIGS. 11A-12D show another embodiment of the handle assembly 450 with the first and second lead screws 460 and 462 .
- the handle assembly 450 is configured to deploy, from a tubular enclosure 420 ( FIG. 11A ), a proximal end portion 410 p of the stent 410 before the distal end portion 410 d of the stent 410 during a “reverse deployment” stent delivery.
- the handle assembly 450 can facilitate accurate and precise positioning of the proximal end portion 410 p of the stent 410 .
- This functionality can be useful for applications in which it is important to align the proximal end of the stent 410 correctly.
- this embodiment can be used to deploy a stent graft in an iliac artery for overlapping and sealing with an implanted aortic stent as it may be desirable to ensure that (1) adequate stent length will be deployed in the iliac artery, and/or (2) no vessels branching from the iliac artery (e.g., the hypogastric artery) are inadvertently blocked.
- the handle assembly 450 may be used in other applications that benefit from accurate and precise placement of a proximal end of the stent.
- the first lead screw 460 can be directly or indirectly coupled to a tubular enclosure that can travel in a distal direction to expose the stent.
- the first lead screw 460 can be in mechanical communication with the top cap 424 of the delivery catheter such that distal translation of the first lead screw 460 actuates corresponding distal translation of the top cap 424 .
- the first lead screw 460 can be coupled to a proximal coupler 440 , which is in turn coupled to the tip tube 430 , and the tip tube 430 is coupled to the top cap 424 .
- the coupling between the first lead screw 460 and the top cap 424 can include any other suitable mechanical communication between the first lead screw 460 and the top cap 424 , such as the direct or indirect methods described above with respect to the embodiment of FIGS. 6A-6E .
- the coupling can additionally or alternatively include any suitable kind of coupling that effectuates movement of the distal top cap 424 .
- the second lead screw 462 is directly or indirectly coupled to a distal end portion 410 d of the stent 410 such that translation of the second lead screw 462 actuates corresponding translation of the distal end portion 410 d of the stent 410 .
- the second lead screw 462 can be configured to be in mechanical communication with the distal coupler 442 ( FIG. 12C ), which is coupled to the inner shaft 432 , and the inner shaft 432 is engaged with the distal end portion 410 d of the stent 410 by the leading collet 428 . More particularly, as shown in FIG.
- the second lead screw 462 has a coupler engagement surface 464 moving within a neck 444 of the distal coupler 442 such that when second lead screw 462 moves proximally enough across the neck 444 , the coupler engagement surface 464 will abut and engage the distal coupler 442 . After this engagement occurs, additional proximal movement of the second lead screw 462 will cause corresponding proximal advancement of the distal coupler 442 , the inner shaft 432 , and the distal end portion 410 d of the stent 410 .
- the coupling between the second lead screw 462 and the distal end portion 410 d of the stent 410 can include any suitable mechanical communication.
- FIG. 13 is a partially transparent, isometric view of a portion of a handle assembly 550 configured in accordance with another embodiment of the technology.
- the handle assembly 550 can include a first lead screw 560 having a first pitch and a second lead screw 562 having a second pitch different from the first pitch. Similar to the handle assemblies in the embodiments described above, one of the lead screws 560 or 562 is in mechanical communication with a tubular enclosure surrounding a stent, and the other lead screw 560 or 562 is in mechanical communication with either a proximal or distal end portion of the stent.
- the first and second lead screws 560 and 562 can be of opposite handedness and engaged with a shaft 564 such that a clockwise or counterclockwise rotation of the shaft 564 will cause the lead screws 560 , 562 to axially translate in opposite directions.
- second lead screw 562 can be internally threaded with a thread corresponding to the pitch and handedness of first lead screw 560 , such that the first lead screw 560 can pass longitudinally within the second lead screw 562 as the lead screws 560 , 562 axially translate.
- FIG. 14 illustrates a handle assembly 650 configured in accordance with yet another embodiment of the technology.
- the handle assembly 650 can include a series of coaxial, nested first and second racks 660 and 662 that engage with respective first and second pinions 670 and 672 such that the movements of racks 660 , 662 and pinions 670 , 672 are interrelated by gearing.
- One of the racks 660 or 662 can be configured to be coupled to a tubular enclosure (e.g., a catheter or top cap), and the other rack 660 or 662 can be configured to be coupled to a stent (e.g., using similar attachment mechanisms as described above).
- actuation inputs that induce opposing movement of the racks 660 and 662 .
- rotation of either the first pinion 670 or the second pinion 672 by a handle component will effectuate the simultaneous longitudinal translations of the first and second racks 660 and 662 in opposite directions.
- actuation of either the first rack 660 or the second rack 662 by a handle component will be translated through the gearing to effectuate the simultaneous longitudinal translation of the other rack 660 or 662 in an opposite direction.
- the pitches of the racks 660 , 662 and the pinions 670 , 672 can vary to facilitate different absolute and relative rates of travel of the racks 660 , 662 for each revolution of the pinions 670 , 672 .
- the handle assembly 650 can include suitable additional features, and/or have a different suitable gearing configuration.
- the handle assemblies described above can include a delay system that delays the synchronized actions of exposing a stent and axially compressing the stent until after a portion of the stent is exposed.
- the delay system delays mechanical communication between a moving position compensating element and the stent until a predetermined portion of the stent is exposed from a tubular enclosure.
- the delay system delays movement of the position compensating element until a predetermined portion of the stent is exposed from the tubular enclosure.
- the delay can be based on, for example, the distance that the tubular enclosure must travel before beginning to expose the stent.
- the delay system can accordingly avoid premature radial expansion of the stent within the tubular enclosure.
- FIG. 6D illustrates one embodiment of a delay system in which there is a spatial longitudinal offset between the proximal coupler 240 and the coupler engagement surface 264 of the second lead screw 262 .
- the longitudinal offset corresponds to a predetermined delay distance.
- rotation of the handle actuates both lead screws 260 , 262 , but during an initial delay lasting until the coupler engagement surface 264 has traversed the predetermined delay distance, rotation of the handle can result in translation of first lead screw 260 to partially expose the stent without resulting in axial compression of the stent.
- FIG. 12C illustrates another embodiment of a delay system in which the distal coupler 442 with the neck 444 is responsible for a delay in synchronization, where the length of the neck 444 is equal to a predetermined delay distance.
- rotation of portions of the handle assembly 450 actuates both lead screws 460 , 462 , but during an initial delay lasting until the coupler engagement surface 464 has traversed the predetermined delay distance across the coupler neck 444 , rotation of the handle can result in translation of the first lead screw 460 to partially expose the stent, without resulting in axial compression of the stent.
- the proximal or distal coupler can be in a reverse configuration with respect to the uncovering element and the position compensating element, and/or the delay system can include other components to facilitate a delay.
- the handle assembly does not include a delay system to delay axial compression of the stent.
- the simultaneous actions of exposing the stent and axially compressing the stent can be carefully synchronized (e.g., with no delay of either action) with relative rates appropriate so that a suitable amount of axial compression is performed at the same time the stent is initially exposed.
- the housing can include a mechanism that operates additionally or alternatively to the axial compression slider 280 ( FIG. 6E ) and radially compresses the stent diameter after partial deployment.
- the handle assembly can include a repositioning ring 281 that, when moved longitudinally along the axis of the housing, can be used to reduce the outer profile of a stent that has been axially compressed to a radially expanded state (e.g., by simultaneous auto-compression as described above, or by an independent axially compressing component).
- the repositioning ring 281 can be in mechanical communication with an end portion of the stent by a push or pull tube such that proximal or distal movement of the repositioning ring 281 causes corresponding movement of an end of the stent, thereby extending and radially contracting the stent.
- the stent can be undeployed by backdriving the shaft portion of the handle, rotating the shaft portion in a direction opposite the direction required for deployment, such as to reverse the paths of the lead screws. In this reverse deployment, the stent becomes elongated and radially compressed, and the sheath recovers the exposed portion of the stent. Once the stent returns to its radially compressed state, the device operator can reposition the stent relative to the surrounding environment.
- the housing further includes a rotational control mechanism 350 that limits rotation of the shaft portion to rotation in a deployment direction (i.e., the direction that actuates stent deployment).
- a rotational control mechanism 350 limits rotation of the shaft portion to rotation in a deployment direction (i.e., the direction that actuates stent deployment).
- the rotational control mechanism 350 can prevent axial compression of the stent when the stent is still radially constrained in the tubular enclosure, as well as selectively lock against reverse deployment while stent deployment is in progress.
- the rotational control mechanism 350 can be selectively disengaged so as to selectively permit rotation in the direction opposite the deployment direction, such as to permit reverse deployment.
- the shaft portion can be rotated in the direction opposite the deployment direction in order to reconstrain the stent within the tubular enclosure.
- the handle assembly can allow repositioning of the entire stent even after the stent has been partially deployed, if so desired.
- a locking collar can define at least one channel 352 and the rotatable shaft portion can define at least one spring tab 354 .
- the spring tab 354 flexes to accommodate rotation of the shaft portion in the deployment direction, but the spring tab 354 engages and stops against the channel 352 when the shaft portion is rotated in the direction opposite of the deployment direction.
- tactile and/or audio clicking feedback can inform the handle operator that he or she has rotated the shaft in an impermissible direction.
- the locking collar can include multiple channels 352 (e.g., four channels 352 equally circumferentially distributed around the collar), such that a single spring tab 354 on the shaft portion permits no more than ninety degrees of rotation in the non-deployment direction.
- the rotational control mechanism 350 can include any suitable number of channels 352 and/or spring tabs 354 . Disengagement of the rotational control mechanism 350 can be performed, for example, by sliding the locking collar distally or proximally out of the rotational path of the spring tab 354 . For example, as shown in FIG.
- the locking collar can be completely removed to disengage the rotational control mechanism 350 .
- the housing can additionally or alternatively include other suitable features for selectively restraining rotation of the shaft portion to one direction.
- the housing additionally or alternatively includes other control mechanisms that selectively prevent rotation in a deployment direction.
- the housing can include an additional or alternative rotational control mechanisms that prevent rotation of the shaft portion in the deployment direction until intentional steps are taken to disengage the rotational control mechanism, such as to prevent premature deployment of the stent (e.g., when the delivery catheter is not yet at the target area).
- the handle assembly can include one or more points of entry for contrast fluid.
- the distal coupler 242 can be coupled to contrast tubing 244 to facilitate injection of contrast fluid through the delivery catheter to the stent region.
- the injected contrast fluid aids in imaging the target area surrounding the stent for purposes of advancing the delivery catheter and positioning and aligning the stent during deployment.
- the distal coupler 242 can include fluid-tight seal 246 that prevents contrast fluid and/or recirculating blood from entering the handle assembly.
- the fluid-tight seal 246 can include, for example, one or more o-rings.
- the distal coupler 242 can additionally or alternatively include other suitable sealing features.
- the distal coupler 242 and sealing mechanism 246 may be in contact with recirculating blood
- the distal coupler 242 and sealing mechanism 246 can be made of any suitable biocompatible material.
- other proximal and/or distal couplers in handle assembly can be coupled to contrast tubing, and/or the handle assembly can include other fluid-tight couplers as appropriate.
- the couplers for introducing couplers can define a circular, annular space or other suitable non-circular shapes.
- a method for implanting a stent graft at a target area for treatment of an aneurysm includes: advancing, toward the target area, a catheter comprising a tubular enclosure covering the stent graft; positioning the stent graft proximate to the target area; deploying the stent graft; allowing the stent graft to anchor in or at the target area; and withdrawing the catheter from the target area.
- Deploying the stent graft can include effectuating simultaneous, opposing translations of first and second handle components such that the first the handle component longitudinally displaces the tubular enclosure in a first direction, and the second handle component axially compresses the stent graft in a second direction opposite the first direction.
- the method is described further with reference to particular handle assemblies shown in FIGS. 16A-18E , but the method is not limited to use of the handle assemblies described herein.
- the method is primarily described in regards to deploying a specific design of stent graft, it should be understood that the method can similarly be used to deploy other kinds of stent grafts or endografts, a bare stent, or any suitable kind of stent.
- advancing the catheter can involve entry into a blood vessel using a percutaneous technique such as the well-known Seldinger technique.
- a practitioner or device operator can displace the tubular enclosure in a proximal direction to expose only a portion of the stent graft, constrain a distal endpoint of the stent graft in a radially compressed state, and axially compress the stent graft to radially expand only the exposed portion of the stent graft.
- the device operator can initially rotate a shaft portion of handle to move the outer sheath 724 and expose a portion of the stent graft 710 (e.g., 2-3 inches).
- a delay system can stall any stent graft compression resulting from this initial rotation, though in other embodiments some amount of stent graft compression can automatically occur during this initial rotation.
- the top cap 722 can still constrain the distal end of the stent graft after this initial handle rotation.
- Proximal movement of an axial compression slider which is coupled to the distal end of the stent graft 710 d by leading collet 728 , pulls leading collet 728 and distal stent graft end 710 d proximally, which axially compresses and radially expands the exposed portion of the stent graft, as shown in FIG. 16A .
- the practitioner can view, through imaging methods and/or use contrast fluids and radiopaque markers, the rotational and longitudinal orientation of the exposed stent graft.
- the device operator can radially collapse the stent graft down to an outer profile small enough for stent graft repositioning.
- distal movement of the axial compression slider pushes leading collet 728 and distal stent graft end 710 d distally, which tensions and radially collapses the exposed portion of the stent graft to a degree suitable for repositioning.
- the repositioning process can repeat until the practitioner is satisfied.
- the method can additionally or alternatively include resheathing the exposed stent graft with the tubular enclosure.
- the device operator can rotate (backdrive) the shaft portion of the handle in the direction opposite that for actuating deployment, in order to reposition the sheath over the previously exposed portion of the stent graft.
- the device operator can release the distal end of the stent graft from its radially compressed state.
- the device operator can move a tip slider in a distal direction to remove the top cap 722 from the stent graft, thereby releasing the distal end of the stent graft, as shown in FIG. 16B .
- the method can involve other actuation means, such as rotating a tip screw, to remove the top cap or other appropriate enclosure.
- the device operator can simultaneously further expose the stent graft by displacing the tubular enclosure and axially compress the stent graft by advancing the unexposed proximal end of the stent graft as the tubular enclosure is displaced, thereby compensating for stent graft foreshortening. For example, shown in FIG.
- the device operator can manipulate the handle to induce opposing translations of first and second handle components, where one handle component longitudinally displaces the tubular enclosure (e.g., outer sheath 224 ) in a proximal direction while the other handle component axially compresses the stent graft with a distally-directed force (advancing a proximal end of the stent graft 710 d via trailing collet 226 ).
- one handle component longitudinally displaces the tubular enclosure (e.g., outer sheath 224 ) in a proximal direction while the other handle component axially compresses the stent graft with a distally-directed force (advancing a proximal end of the stent graft 710 d via trailing collet 226 ).
- the device operator manipulates the handle to induce opposing translations of first and second handle components, where one handle component longitudinally displaces the tubular enclosure (e.g., top cap 824 via tip tube 830 ) in a distal direction while the other handle component axially compresses the stent graft 810 with a proximally-directed force (e.g., retracting a distal end of the stent graft 810 d via leading collet 828 and inner shaft 832 ).
- a proximally-directed force e.g., retracting a distal end of the stent graft 810 d via leading collet 828 and inner shaft 832 .
- FIGS. 18A-18E show an exemplary embodiment of the method used specifically to deliver stent graft grafts for treatment of an abdominal aortic aneurysm.
- the method deploys stent grafts with D-shaped cross-sections as described in U.S. Patent Application Publication No. 2011/0130824, where the flat portions of the D-shaped stent grafts press against each other to form a straight septum and the curved portions of the D-shaped stent grafts press against the aortic wall to form a seal against the aortic wall.
- the figures show and are described with reference to the delivery device embodiment of FIG.
- FIGS. 18A-18E show and are generally described with respect to the operations of handle of only one delivery device, which is typically identical to the delivery device used for deploying the depicted contralateral stent graft.
- stent grafts 910 are positioned superior to the aneurysm and partially unsheathed.
- the catheters of two instances of the delivery system have been advanced toward the target area in an aorta using various techniques, such as over-the-wire (guidewires not shown), with a first catheter advanced along the left iliac artery, and a second catheter advanced along the right iliac artery.
- the catheters have been advanced until the top caps 922 and stent grafts 910 are positioned superior to the aneurysm, where radiopaque markers can aid correct placement of the stent grafts.
- the catheters cross paths within the aneurysm such that the distal end of each catheter approach and/or touch the side of the aortic wall that is opposite the side of entry.
- the crossing of catheters may induce a stent graft 910 passing through the aneurysm from the left iliac artery to appose the right side of the aortic wall, and a stent graft 910 entering from the right iliac artery to appose the left side of the aortic wall.
- first and second lead screws 960 and 962 On each delivery device, rotation of handle portion 952 a has caused internal threads of handle portion 952 a to simultaneously engage first and second lead screws 960 and 962 , resulting in proximal translation of first lead screw 960 and distal translation of second lead screw 962 .
- Proximal movement of first lead screw 960 has caused outer sheath 924 to retract and expose a portion of stent graft 910 , though top cap 922 still constrains the distal end of stent graft 910 .
- distally-travelling lead screw 962 has not traversed the predetermined delay distance, such that lead screw 962 does not yet axially compress the exposed stent graft 910 .
- the stent grafts 910 are slightly axially compressed such that the exposed portions of stent grafts 910 are slightly radially expanded.
- the axial compression slider represented by box 980
- distal bearing assembly 982 in mechanical communication with the distal end of stent graft 910
- axial compression slider induces and/or supplements the radial self-expansion of the stent graft 910 .
- tip slider (represented by box 990 ) is coupled to axial compression slider 980 by removable slider collar 994 , top cap 922 moves in tandem with the distal end of the stent graft 910 . Additionally, axial compression slider 980 can optionally be moved distally to tension and radially collapse the exposed portion of the stent graft 910 .
- the longitudinal position of the axial compression slider 980 corresponds to the degree of radial expansion, so the device operator can move the axial compression slider 980 both proximally and distally to adjust the radial expansion and radial contraction, respectively, of the stent graft 910 .
- the device operator can adjust the longitudinal position of the catheter as a whole by withdrawing and/or advancing the entire catheter, to adjust the longitudinal position of the stent grafts 910 . Partial radial expansion of the stent grafts, when viewed under fluoroscopy by the device operator, aids optimal rotational and/or longitudinal positioning of the stent grafts 910 , both relative to each other and relative to the aortic wall.
- each partially deployed stent graft 910 is longitudinally positioned such that its graft material is aligned with (just inferior to) a renal artery in order to maximize overlap between the anchoring bare stent portion of stent graft 910 and healthy aortic neck tissue, without resulting in the graft material blocking blood flow to the renal arteries.
- the stent grafts 910 are optimally positioned with a corresponding longitudinal offset in order to accommodate the offset renal arteries without sacrificing coverage nor blocking blood flow to the renal arteries.
- each partially deployed stent graft 910 is rotationally oriented such that the flat portions of the D-shaped stent grafts 910 press against each other to form a straight septum and the curved portions of the D-shaped stent grafts 910 press against the aortic wall to form a seal against the aortic wall.
- the stent grafts are longitudinally and rotationally oriented in the desired manner, and further proximal retraction of axial compression slider 980 has induced additional radial expansion of the stent graft 910 to cause stent graft 910 to press against the aortic wall.
- the two stent grafts 910 in conjunction can be radially expanded to a have a deployment radius sufficiently large to form a complete seal between them, as well as with the aorta wall superior to the aneurysm. This seal can be verified or confirmed by introducing contrast fluid through the catheter (e.g., through contrast tubing in the handles) and viewing whether the expanded stent grafts 910 prevent contrast flow across the sealed region.
- axial compression slider 980 locks longitudinally in place with notches on the housing, in anticipation of full deployment of the stent grafts.
- stent grafts 910 are freed from top cap 922 and allowed to self-expand against each other and against the aortic wall. If the stent grafts 910 have barbs or other suitable anchoring mechanisms, the stent grafts have become anchored at their deployed position.
- slider collar 994 has been removed to allow tip slider 990 to move independently of axial compression slider 980 .
- the tip slider 990 has been moved distally to cause top cap 922 to move correspondingly move distally and release the distal end of the stent graft.
- slider 990 may couple directly to axial slider 980 .
- the device operator may choose to inject contrast fluid through one or both catheters, with contrast couplers described above, in order to verify quality of the seal formed between the stent grafts and with the aortic wall.
- first and second lead screws 960 and 962 Following verification of position and seal, resumed rotation of the handle portion in each delivery device again effectuates the opposing longitudinal translations of the first and second lead screws 960 and 962 .
- the first lead screw 960 continues to proximally retract outer sheath 924 and the second lead screw 962 distally advances the proximal end of stent graft 910 .
- FIG. 18E the catheters have been withdrawn from the stent grafts 910 following full deployment of the stent grafts.
- the two simultaneous actions of the lead screws 960 and 962 during deployment have compensated for the displacement effects of stent graft foreshortening that would otherwise occur, thereby ensuring that the distal ends of stent grafts 910 maintain their respective positions during deployment.
- the stent grafts of FIG. 18E are shown with inferior ends terminating within the aneurysm. However, in other embodiments, each stent graft can extend into and anchor with a respective iliac artery.
- the inferior graft end of the stent grafts 910 can terminate in the common iliac arteries immediately superior to the internal iliac arteries so as not to block blood flow to the internal iliac arteries.
- the stent grafts 910 can be positioned in any suitable manner.
- FIGS. 19A-19C show another exemplary embodiment of the method, extending that described with respect to 18 A- 18 E.
- This specific application of the method deploys iliac stent grafts 1010 , each of which couples to and extends a respective stent graft 910 deployed as described above.
- the figures show and are described with reference to the delivery device embodiment of FIG. 12A , but it should be understood that any suitable embodiments and variations of the device can similarly be used in the method.
- FIGS. 19A-19C depict the operations of handle of only one delivery device, which is typically identical to the delivery device used for deploying the depicted contralateral stent graft.
- stent grafts 1010 are partially deployed adjacent to previously deployed stent grafts 910 .
- the catheter of each delivery device was advanced over guidewires toward the aneurysm and into the lumen of a corresponding stent graft 910 .
- the proximal graft end of each stent graft 1010 was optimally aligned to be immediately superior to the internal iliac arteries, so as not to block the internal iliac arteries.
- the stent grafts 1010 can be positioned in any suitable manner.
- first lead screw 1060 which is in mechanical communication through tip tube 1030 to top cap 1024 , has caused top cap 1024 to advance distally and expose a portion of stent graft 1010 .
- the stent graft exposure began at the proximal end of the stent graft, which radially expanded off of docking tip 1026 .
- proximally-travelling lead screw 1062 travels a predetermined delay distance before it becomes in mechanical communication with the distal end of stent graft 1010 through inner shaft 1032 . Once the lead screw 1062 has traversed the predetermined delay distance, its proximal translation axially compresses the stent graft 1010 by proximally retracting the distal end of the stent graft 1010 .
- the top caps 1024 , and/or associated outer sheath if present, have advanced distally enough to release the distal ends of the stent grafts 1010 , thereby freeing the distal end of the stent graft 1010 .
- the superior ends of stent grafts 1010 are expanded within in the inferior ends of stent grafts 910 , such as to extend the lumens of stent grafts 910 at a joining within the aneurysm.
- the stent grafts 1010 can couple to the stent grafts 910 in any suitable location.
- the device operator may choose to inject contrast fluid through one or both catheters, using contrast couplers as described above, in order to verify quality of seal formed between stent grafts 910 and 1010 , and/or with the iliac arterial wall.
- FIG. 19C the catheters have been withdrawn from the stent grafts 1010 following full deployment of the stent grafts.
- the handle assemblies and stent delivery methods shown and described herein offer several advantages over previous devices and stent delivery methods.
- the handle assemblies provide for straightforward delivery of a stent graft to an artery while maintaining initial stent graft marker positions relative to a destination arterial wall.
- Embodiments employing opposing screws provide a user with the ability to deliver a stent graft at a high force with relatively little mechanical effort. This allows a user to exercise improved control over the delivery process, such as by enabling the user to control the outer diameter and/or length of the deployed stent.
- the mechanisms disclosed herein provide effective push/pull motion while minimizing the number of parts, assembly time, and cost.
- the push/pull components move at relative rates according to the predetermined payout ratio (which, in the lead screw embodiment described above, is dependent on the difference in pitch between the lead screws), and determine the rate of stent deployment and degree of stent radial expansion.
- the rate of stent deployment and degree of stent radial expansion can allow the handle assemblies to maintain a low profile and minimize the overall bulk of the delivery device.
Landscapes
- Health & Medical Sciences (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Cardiology (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Transplantation (AREA)
- Heart & Thoracic Surgery (AREA)
- Vascular Medicine (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Media Introduction/Drainage Providing Device (AREA)
- Prostheses (AREA)
Abstract
Description
- The present application claims priority to each of the following U.S. Provisional patent applications:
- (A) U.S. Provisional Patent Application No. 61/681,907, filed on Aug. 10, 2012 and entitled “HANDLE ASSEMBLIES FOR STENT GRAFT DELIVERY SYSTEMS AND ASSOCIATED SYSTEMS AND METHODS”; and
- (B) U.S. Provisional Patent Application No. 61/799,591, filed Mar. 15, 2013 and entitled “HANDLE ASSEMBLIES FOR STENT GRAFT DELIVERY SYSTEMS AND ASSOCIATED SYSTEMS AND METHODS.”
- Each of the foregoing applications is incorporated herein by reference in its entirety.
- The present technology relates to treatment of abdominal aortic aneurysms. More particularly, the present technology relates to handle assemblies for stent graft delivery systems and associated systems and methods.
- An aneurysm is a dilation of a blood vessel of at least 1.5 times above its normal diameter. The dilated vessel forms a bulge known as an aneurysmal sac that can weaken vessel walls and eventually rupture. Aneurysms are most common in the arteries at the base of the brain (i.e., the Circle of Willis) and in the largest artery in the human body, the aorta. The abdominal aorta, spanning from the diaphragm to the aortoiliac bifurcation, is the most common site for aortic aneurysms. Such abdominal aortic aneurysms (AAAs) typically occur between the renal and iliac arteries, and are presently one of the leading causes of death in the United States.
- The two primary treatments for AAAs are open surgical repair and endovascular aneurysm repair (EVAR). Surgical repair typically includes opening the dilated portion of the aorta, inserting a synthetic tube, and closing the aneurysmal sac around the tube. Such AAA surgical repairs are highly invasive, and are therefore associated with significant levels of morbidity and operative mortality. In addition, surgical repair is not a viable option for many patients due to their physical conditions.
- Minimally invasive endovascular aneurysm repair (EVAR) treatments that implant stent grafts across aneurysmal regions of the aorta have been developed as an alternative or improvement to open surgery. EVAR typically includes inserting a delivery catheter into the femoral artery, guiding the catheter to the site of the aneurysm via X-ray visualization, and delivering a synthetic stent graft to the AAA via the catheter. The stent graft reinforces the weakened section of the aorta to prevent rupture of the aneurysm, and directs the flow of blood through the stent graft away from the aneurysmal region. Accordingly, the stent graft causes blood flow to bypass the aneurysm and allows the aneurysm to shrink over time.
- Most stent and stent graft systems for cardiovascular applications (e.g., coronary, aortic, peripheral) utilize self-expanding designs that expand and contract predominantly in the radial dimension. However, other system include braided stent grafts that are delivered in a radially compressed, elongated state. Upon delivery from a delivery catheter, the stent graft will radially expand and elastically shorten into its free state. In other words, the effective length of the stent graft changes as its diameter is forced smaller or larger. For example, a stent graft having a shallower, denser helix angle will result in a longer constrained length. Once the stent graft is removed from a constraining catheter, it can elastically return to its natural, free length.
- Delivering a stent graft to an artery requires accurate and precise positioning of the stent graft relative to a target location in the destination artery. For example, a misplaced stent graft can block flow to a branching artery. Some stent graft delivery systems utilize one or more markers (e.g., radiopaque markers) to establish the alignment of the stent graft relative to the artery wall. However, the location of the radiopaque markers on the stent graft can move relative to an initial marker position because of the change in the stent graft's effective length upon deployment, as described above. Accordingly, after deployment of a stent graft, the stent graft (e.g., its proximal or distal edge) may miss the target point in the artery. Therefore, there are numerous challenges associated with the accurate positioning of stent grafts that change dimensions in both the radial and longitudinal directions.
-
FIG. 1A is an isometric view of a stent graft delivery system configured in accordance with an embodiment of the technology. -
FIGS. 1B and 1C are functional schematic diagrams of a portion of a handle assembly system configured in accordance with embodiments of the technology. -
FIG. 2A is an isometric view of a handle assembly configured in accordance with an embodiment of the technology. -
FIGS. 2B and 2C are side views of a delivery catheter of a stent graft delivery system configured in accordance with an embodiment of the technology. -
FIGS. 2D and 2E are side views of collets of a stent graft delivery system configured in accordance with an embodiment of the technology. -
FIGS. 3A-3C are side views of a delivery catheter of a stent graft delivery system configured in accordance with an embodiment of the technology. -
FIGS. 4A-4E are front and side views of collets of a stent graft delivery system configured in accordance with various embodiments of the technology. -
FIGS. 5A and 5B are partial side views of a handle assembly and a housing, respectively, configured in accordance with various embodiments of the technology. -
FIG. 6A is a partial cut-away view of a handle assembly configured in accordance with an embodiment of the technology. -
FIGS. 6B-6D are enlarged partial cut-away views of portions of the handle assembly ofFIG. 6A . -
FIG. 6E is an isometric view of a portion of the handle assembly ofFIG. 6A . -
FIG. 7 is an enlarged partial cut-away view of a distal portion of the handle assembly configured in accordance with an embodiment of the technology. -
FIG. 8A is an isometric view of a handle assembly configured in accordance with another embodiment of the technology. -
FIG. 8B is an enlarged, partially translucent isometric view of a portion of the handle assembly ofFIG. 8A . -
FIG. 9 is a partial cut-away isometric view of a handle assembly configured in accordance with another embodiment of the technology. -
FIGS. 10A and 10B are side and partial cut-away views, respectively, of a handle assembly configured in accordance with another embodiment of the technology. -
FIG. 11A is an isometric view of a stent graft delivery system configured in accordance with another embodiment of the technology. -
FIGS. 11B and 11C are side views of a delivery catheter of the stent graft delivery system ofFIG. 11A configured in accordance with an embodiment of the technology. -
FIG. 11D is a side view of a collet of the a stent graft delivery system ofFIG. 11A configured in accordance with an embodiment of the technology. -
FIG. 12A is a partial cut-away view of a handle assembly configured in accordance with an embodiment of the technology. -
FIGS. 12B-12D are enlarged partial cut-away views of portions of the handle assembly ofFIG. 12A . -
FIG. 13 is a partially translucent isometric view of a portion of a handle assembly configured in accordance with another embodiment of the technology. -
FIG. 14 is a partially translucent isometric view of a portion of a handle assembly configured in accordance with another embodiment of the technology. -
FIG. 15A is a partial isometric view of a portion of a handle assembly configured in accordance with an embodiment of the technology. -
FIG. 15B is an enlarged view of a portion of the handle assembly ofFIG. 15A . -
FIG. 15C is a partially translucent side view of a portion of the handle assembly ofFIG. 15A . -
FIGS. 16A and 16B are partially schematic representations of a method of stent graft delivery in accordance with an embodiment of the technology. -
FIG. 17 is a partially schematic representation of a method of stent graft delivery in accordance with an embodiment of the technology. -
FIGS. 18A-18E illustrate a stent delivery method in accordance with an embodiment of the technology. -
FIGS. 19A-19C illustrate a stent delivery method in accordance with another embodiment of the technology. - The present technology is directed toward handle assemblies for stent delivery systems and associated systems and methods. Certain specific details are set forth in the following description and in
FIGS. 1A-19C to provide a thorough understanding of various embodiments of the technology. For example, many embodiments are described below with respect to the delivery of stent grafts that at least partially repair AAAs. In other applications and other embodiments, however, the technology can be used to repair aneurysms in other portions of the vasculature. Furthermore, the technology can be used to deliver a stent for any suitable purpose in any suitable environment. Other details describing well-known structures and systems often associated with stent grafts and associated delivery devices and procedures have not been set forth in the following disclosure to avoid unnecessarily obscuring the description of the various embodiments of the technology. Many of the details, dimensions, angles, and other features shown in the Figures are merely illustrative of certain embodiments of the technology. For example, dimensions shown in the Figures are representative of particular embodiments, and other embodiments can have different dimensions. A person of ordinary skill in the art, therefore, will accordingly understand that the technology may have other embodiments with additional elements, or the technology may have other embodiments without several of the features shown and described below with reference toFIGS. 1A-19C . - In this application, the terms “distal” and “proximal” can reference a relative position of the portions of an implantable stent graft device and/or a delivery device with reference to an operator. Proximal refers to a position closer to the operator of the device, and distal refers to a position that is more distant from the operator of the device. Also, for purposes of this disclosure, the term “helix angle” refers to an angle between any helix and a longitudinal axis of the stent graft.
- As shown in
FIGS. 1A-1C , various embodiments of astent delivery system 100 can include adelivery catheter 120 having a shaft ortubular enclosure 124 on a distal end portion of thecatheter 120, a braided stent 110 (FIGS. 1B and 1C ) constrained within thetubular enclosure 124, and ahandle assembly 150 at a proximal end portion of thedelivery catheter 120. Various embodiments of the technology may be used to deliver the braided 110 stent to a target area within a body lumen of a human. For example, one embodiment of thestent delivery system 100 can be configured to deploy a stent at a target location in an aorta such that at least a portion of the stent is superior to an aortic aneurysm. As another example, another embodiment of thestent delivery system 100 can be configured to deploy a stent at a target location in an iliac artery such that at least a portion of the stent is inferior to an aortic aneurysm. Further embodiments of the technology may be used to deliver a stent to any suitable target area. - 1.1 Selected Embodiments of Delivery Catheters and Stents
- The
delivery catheter 120 of various embodiments can include a distal end portion insertable into a body lumen within a human and navigable toward a target area, and nested components configured to mechanically communicate actions of thehandle assembly 150 to distal end portion of thedelivery catheter 120. The stent 110 (FIGS. 1B and 1C ) can be constrained in a radially compressed state at the distal end portion of thedelivery catheter 120. In some embodiments, thedelivery catheter 120 has a diameter of approximately 14 Fr, but in other embodiments thedelivery catheter 120 can have a greater diameter or a smaller diameter, such as 10 Fr or 8 Fr. -
FIGS. 2A-2E illustrate an embodiment of astent delivery system 200 configured in accordance with another embodiment of the technology, andFIGS. 3A-3C illustrate portions of adelivery catheter 220 of thestent delivery system 200 ofFIGS. 2A-2C . As shown inFIG. 2A , thestent delivery system 200 can include thedelivery catheter 220 and handleassembly 250 operably coupled to thedelivery catheter 220. As shown inFIGS. 2B , 2C, and 3A-3C, the distal end portion ofdelivery catheter 220 includes a distaltop cap 222 and anouter sheath 224 that engage astent 210. More specifically, the distaltop cap 222 covers and constrains at least adistal end portion 210 d of thestent 210 in a radially compressed configuration, and theouter sheath 224 covers and constrains at least aproximal end portion 210 p of thestent 210 in a radially compressed configuration. In some embodiments, thetop cap 222 andouter sheath 224 can overlap or meet edge-to-edge so as to entirely cover thestent 210, though in other embodiments thetop cap 222 andouter sheath 224 can leave a medial portion of thestent 210 uncovered. Thetop cap 222 can have a tapered distal end to help navigate the catheter through a patient's vasculature, and/or a radiused proximal edge that may reduce snagging or catching on vasculature or other features during catheter retraction after stent deployment. -
FIGS. 11A-12D show an embodiment of adelivery system 400 configured in accordance with another embodiment of the technology. Similar to thestent delivery system 200 ofFIGS. 2A-2E , thestent delivery system 400 ofFIGS. 11A-12D can include adelivery catheter 420 and handleassembly 450 operably coupled to thedelivery catheter 420. As shown inFIGS. 11B and 11C , the distal end portion of thedelivery catheter 420 can include a distaltop cap 424 having a tubular enclosure that covers and constrains the entirety of thestent 410 in a radially compressed configuration. Removing thetop cap 424 in a distal direction can expose thestent 410. Similar to thetop cap 222 shown inFIGS. 2B and 2C , thetop cap 424 can have a tapered distal end and/or radiused proximal edge. - Other embodiments of delivery catheters can have distal end portions that include an outer sheath that covers and constrains the entirety of the stent in a radially compressed configuration such that retraction of the outer sheath in a proximal direction exposes the stent. Furthermore, in some embodiments, the
top cap top cap top cap top cap top cap - As shown in, for example,
FIG. 2B , thestent 210 can be disposed at the distal end portion of thedelivery catheter 220. Thestent 210 can be a bare stent or a stent graft, such as those described in U.S. Application Patent Publication No. 2011/0130824, which is incorporated herein by reference in its entirety. In other embodiments, thestent 210 can be any suitable braided stent or other self-expanding stent. As described above, thestent 210 can be constrained in a radially compressed configuration by thetop cap 222 and/or an outer sheath. Additionally, as shown inFIG. 2C , prior to stent deployment, the stent (not shown) can be axially constrained at the distal end portion of thedelivery catheter 220 with one ormore collets delivery catheter 220. -
FIGS. 4A-4E are front and side views ofvarious collets FIG. 2C ). Generally, thecollets prongs 227, each of which engages an opening on a stent and constrains the longitudinal position of the stent at the point of engagement. Eachprong 227 can have a radius of curvature that matches that of the stent it is configured to engage and a height that exceeds the height of the stent wire by a suitable amount so as to help ensure engagement with the stent. For example, theprongs 227 may have a height about 1.5 times the height of the stent wire. In other embodiments, theprongs 227 may have other suitable heights. The number, arrangement, and particular prong profiles can be suitably tailored to the specific application. For example, thecollets FIG. 4E ) that assists in launching the stent wire into radial expansion during stent deployment. - Delivery systems in accordance with the present technology can include a trailing or proximal collet 226 (
FIGS. 4D and 4E ) coupled to a proximal end portion of a stent, a leading or distal collet 228 (FIGS. 4A-4C ) coupled to a distal end portion of the stent, or both the trailingcollet 226 and the leadingcollet 228. In other embodiments, individual collets can be coupled to other suitable portions of a stent (e.g., a medial portion of a stent). As shown inFIGS. 11B and 11C , in further embodiments one or more end portions of a stent can be coupled to the distal end portion of thedelivery catheter 420 with a smooth,prongless docking tip 426. - Nested components along the
delivery catheters handle assemblies 250 and 450) can be sufficiently flexible to permit navigation and advancement through potentially tortuous paths through a blood vessel, though the degree of flexibility can vary depending on the application (e.g., the location of the target site and/or the path to the target site). The nested components can include a plurality of tubes and/or wires that are configured to push and/or pull various components of the distal end portion of the delivery catheter. As a person of ordinary skill in the art would appreciate, although the components of thedelivery catheters delivery catheters -
FIG. 2C shows an embodiment of thedelivery catheter 220 in which the nested components include atip tube 230, aninner shaft 232, and adilator 236, although in other embodiments thedelivery catheter 220 can include any suitable number of tubes and/or shafts. As shown inFIGS. 6A and 6C , in various embodiments, the nested components can further include one ormore stiffeners 234 disposed within and/or around other nested components. Thestiffener 234 can, for example, axially reinforce a portion of a pushing component (e.g., the inner shaft 232) to increase the column strength of the pushing component. Thestiffener 234 can be made of stainless steel or any other suitably rigid material. In the embodiment shown inFIGS. 2C and 6A , thetip tube 230 is disposed within theinner shaft 232, and theinner shaft 232 is disposed within thedilator 236, with the stiffener 234 (FIG. 6A ) surrounding and reinforcing portions of thetip tube 230 and theinner shaft 232 within thehandle assembly 250. - In the embodiment shown in
FIGS. 2B and 2C , thetip tube 230 is operatively connected to thetop cap 222 such that proximal and distal movement of thetip tube 230 corresponds to longitudinal movement of thetop cap 222. For example, sufficient distal movement of thetip tube 230 can cause thetop cap 222 to move distally enough to release thedistal end portion 210 d of thestent 210, thereby allowing thedistal end portion 210 d of thestent 210 to self-expand. In some embodiments, thetip tube 230 can be made of stainless steel, and in other embodiments thetip tube 230 can additionally or alternatively include any other suitable materials. Furthermore, thetube 230 can include suitable structural reinforcing features, such as a stainless steel braid. - In the embodiment shown in
FIGS. 2A-2E , theinner shaft 232 is operatively connected to the leadingcollet 228 engaged with thedistal end portion 210 d of thestent 210 such that proximal and distal movement of theinner shaft 232 corresponds to longitudinal movement of the leadingcollet 228 anddistal end portion 210 d of thestent 210. In other embodiments, theinner shaft 232 can be in mechanical communication with thedistal end portion 210 d of thestent 210 in other suitable manners. Theinner shaft 232 can permit, within its lumen, telescopic movement of thetip tube 230, thereby allowing longitudinal movement of thetop cap 222 relative to the leadingcollet 228. Theinner shaft 232 can be a tube made of polyimide and/or other suitable materials. - In the embodiment shown in
FIG. 2C , thedilator 236 is operatively connected to the trailingcollet 226, which is in turn engaged with theproximal end portion 210 p of thestent 210 such that proximal and distal movement of thedilator 236 corresponds to longitudinal movement of the trailingcollet 226 and theproximal end portion 210 p of thestent 210. Thedilator 236 can permit, within its lumen, telescopic movement of thetip tube 230 and theinner shaft 232. In turn, theouter sheath 224 can permit, within its lumen, the telescopic movement of thedilator 236. Accordingly, thetop cap 222, the leadingcollet 228, and the trailingcollet 226 may move relative to one another corresponding to relative movement of thetip tube 230, theinner shaft 232, and thedilator 236, respectively. Thedilator 236 can be made from nylon and/or various other suitable materials. - In certain embodiments, the nested components described above with respect to
FIGS. 2C , 6A, and 6C can be used to deliver a stent to an aorta before an aneurysm. In other embodiments, the nested components can be used to deliver stents to other blood vessels, such as the iliac arteries. -
FIGS. 11A-11C show another embodiment of thedelivery catheter 420 in which the nested components include atip tube 430, an inner shaft 432, and adilator 436, although in other embodiments thedelivery catheter 420 can include any suitable number of tubes and/or shafts. As shown inFIGS. 12A and 12D , the nested components can additionally include one or more stiffeners (identified individually as afirst stiffener 434 a and asecond stiffener 434 b, and referred to collectively as stiffeners 434) disposed within and/or around other nested components. Similar to the embodiment ofFIG. 6A , the stiffeners 434 can, for example, reinforce a pushing component for increased column strength of that pushing component. The stiffeners 434 can be made of stainless steel or any other suitably rigid material. In the embodiment shown inFIG. 11C , a portion of thetip tube 430 is disposed within the inner shaft 432, and another portion of thetip tube 430 is disposed within thedilator 436. As shown inFIG. 12A , the first andsecond stiffeners tip tube 430 within thehandle assembly 450. In other embodiments, however, the nested components can be configured in any suitable arrangement. Furthermore, some or all of the nested components can be replaced or supplemented with wires or other suitable control mechanisms. - In the embodiment of
FIGS. 11A-12B , thetip tube 430 is operatively connected to thetop cap 424 such that the proximal and distal movement of thetip tube 430 corresponds to longitudinal movement of thetop cap 424. In particular, sufficient distal movement of thetip tube 430 can cause thetop cap 424 to move distally enough to release thestent 410, thereby allowing the stent to self-expand. Thetip tube 430 can be made of stainless steel and/or other suitable materials. Furthermore, thetube 430 can include suitable structural reinforcing features, such as a stainless steel braid. - As further shown in the embodiment of
FIGS. 11A-12B , the inner shaft 432 is operatively connected to the leadingcollet 428, which is in turn engaged with thedistal end portion 410 d of thestent 410 such that proximal and distal movement of the inner shaft 432 corresponds to longitudinal movement of the leadingcollet 428 and thedistal end portion 410 d of thestent 410. In other embodiments, the inner shaft 432 can be in mechanical communication with thedistal end portion 410 d of thestent 410 in any suitable manner. Within its lumen, the inner shaft 432 can permit telescopic movement of thetip tube 430. The inner shaft 432 can be a tube made of polyimide and/or other suitable materials. - As shown in
FIG. 11C , thedilator 436 can be coupled to adocking tip 426, which engages with theproximal end portion 410 p of thestent 410 at the distal end portion of thedelivery catheter 420. Within its lumen, thedilator 436 can permit telescopic movement of the inner shaft 432 and thetip tube 430. Thedilator 436 is made of nylon and/or other suitable materials. - In certain embodiments, the nested components described above with respect to
FIGS. 11A-12B can be used to deliver a stent to an iliac artery after an aneurysm. In other embodiments, the nested components can be used to deliver stents to other blood vessels, such as the aorta. - Though the above embodiments are described in detail with particular arrangements of nested components, in other embodiments the nested components can be configured in any suitable arrangement. Additionally, other embodiments can include any suitable number of nested push/pull components. Furthermore, some or all of the nested components can be replaced or supplemented with wires or other suitable control mechanisms.
- 1.2 Selected Embodiments of Handle Assemblies
- Various embodiments of handle assemblies can be used in conjunction with other aspects of the
stent delivery systems FIGS. 1B and 1C , thehandle assembly 150 ofFIG. 1A can incorporate various mechanisms to effectuate the opposing displacement of an uncoveringcomponent 160 and aposition compensating component 162 at a predetermined payout ratio, which deploys thestent 110 in a controlled manner. The uncovering component orelement 160 can also configured to expose thestent 110 from thetubular enclosure 124 and allow the exposed portion ofstent 110 to radially self-expand. Theposition compensating component 162 provides an axially compressive force on thestent 110 that counteracts the longitudinal displacement otherwise resulting from changing stent length as thestent 110 radially expands. Generally speaking, as shown inFIG. 1B , theposition compensating component 162 can actuate in a distal direction while the uncoveringelement 160 can actuate in a proximal direction. Alternatively, as shown inFIG. 1C , thepositioning compensating component 162 can actuate in a proximal direction while the uncoveringcomponent 160 can actuate in a distal direction. - The synchronized motion of the uncovering
component 160 and theposition compensating component 162 can control the axial position of the exposed portion of thestent 110. When the ratio of the components' movements is matched to or corresponds to the helix angle of thestent 110, the position of the deployedstent 110 can be maintained relative to a particular destination target location. Although in many applications it is desirable that at least one end of thestent 110 remain stationary during deployment, in some alternative applications it might be desirable to modify the predetermined payout ratio so that the exposed portion of thestent 110 moves in a controlled manner at a predetermined rate. -
FIGS. 5A-12D illustrate various handle assemblies with lead screws configured in accordance with embodiments of the technology. For instance, as shown inFIGS. 5A and 5B, various embodiments of a handle assembly for delivering a stent from a tubular enclosure (e.g., thetubular enclosure 124 ofFIG. 1A ) can include afirst lead screw 260, asecond lead screw 262, and ahousing 270 surrounding at least a portion of each of the first and second lead screws 260 and 262. Thefirst lead screw 260 has a lead thread of a first pitch and a first handedness (i.e., the lead screw has a right-handed or left-handed thread), and is coupled to the tubular enclosure. Thesecond lead screw 262 has a lead thread of a second pitch and a second handedness different from the first handedness, and is coupled to the stent. Thehousing 270 surrounds at least a portion of each of the first and second lead screws 260 and 262, and defines two housing threads, including afirst housing thread 276 with the same pitch and handedness as thefirst lead screw 260 and asecond housing thread 278 with the same pitch and handedness as thesecond lead screw 262. Thehousing 270 andlead screws first housing thread 276 engages thefirst lead screw 260 andsecond housing thread 278 engages thesecond lead screw 262. The engagements between thehousing threads FIG. 5A ) of thehousing 270, and the simultaneous translations deploy the stent from the tubular enclosure. In particular, translation of thefirst lead screw 260 can cause the tubular enclosure to translate to expose the stent and allow the exposed portion of the stent to radially self-expand. At the same time, translation of thesecond lead screw 262 can apply an axially compressive force to the stent that substantially avoids or counterbalances longitudinal displacement of the end of the stent that is initially exposed. - As shown in
FIGS. 5A-12D , various embodiments of handle assemblies can include first and second lead screws that have different handedness such that their rotation in the same direction induces their movement in opposite directions. For example, the first lead screw can have a right-handed thread, and the second lead screw can have a left-handed thread. Alternatively, the first lead screw can have a left-handed thread, and the second lead screw can have a right-handed thread. Since the first and second lead screws have threads of opposite handedness, their concurrent rotation in the same direction will induce their translations in opposite directions. Additionally, the threads of lead screws can be external threads (e.g., as shown inFIG. 5A ) or internal threads. - Furthermore, as shown in
FIGS. 5A-12D , the first and second lead screws in various embodiments of the handle assembly can have different thread pitches such that their concurrent rotation induces their movement at different rates of travel. As shown inFIG. 5A , for example, thefirst lead screw 260, which is in mechanical communication with the tubular enclosure, can have a relatively coarse thread pitch, and thesecond lead screw 262, which is in mechanical communication with the proximal or distal end portion of the stent, can have a relatively fine thread pitch. Alternatively, thefirst lead screw 260 can have a relatively fine thread pitch, while thesecond lead screw 262 can have a relatively coarse thread pitch, or the first and second lead screws 260 and 262 can have substantially equal thread pitches. The ratio of thread pitches corresponds to a predetermined payout ratio of the first and second lead screws 260 and 262 and, in various embodiments, can correspond to the braid angle of the stent. In certain embodiments, for example, the ratio of the coarse thread (e.g., on the first lead screw 260) to the fine thread (e.g., on the second lead screw 262) is approximately 1.5:1. Payout ratios ranging from about 1:1 to about 2:1 have also been shown to provide acceptable stent deployment. In other embodiments, the payout ratio of the first and second lead screws 260 and 262 can differ depending on the application. For example, both the first and second lead screws 260 and 262 can have relatively fine thread pitches that may allow for precise deployment, since a fine lead screw axially translates less distance per rotation than a coarse lead screw would for the same rotation. In this manner, the specific pitches and/or the ratio of the pitches can be selected to achieve a particular degree of mechanical advantage, a particular speed and precision of stent deployment, and/or a selected predetermined payout ratio. - As shown in
FIGS. 5A-12D , the first and second lead screws can have cross-sections that enable them to longitudinally overlap and slide adjacent to each other along the longitudinal axis of the handle. As shown inFIG. 5A , for example, at least the threaded lengths of the lead screws 260, 262 are “half” lead screws, each having an approximately semi-circular cross-section and arranged so that the lead screws 260, 262 are concentric. When mated longitudinally, the semi-circular cross-sections cooperate to define a lumen through which various push/pull tubes, wires, and/or other suitable mechanisms for stent deployment can travel and extend distally into the delivery catheter. In other embodiments, the first and second lead screws 260 and 262 can have other complementary arcuate cross-sections, and/or other suitable cross-sectional shapes. - In various embodiments, the lead screws 260 and 262 can have an initial offset arrangement prior to stent deployment such that the first and second lead screws 260 and 262 have no longitudinal overlap within the
housing 270 or overlap for only a portion of the length of the lead screws 260, 262. Upon rotation of thehousing 270, the lead screws 260, 262 can translate relative to one another to increase their longitudinal overlap. In certain embodiments, for example, the lead screws 260, 262 in the initial offset arrangement have an initial overlap area of approximately five to nine centimeters (e.g., seven centimeters). In operation, the handle assembly can be configured such that rotation of thehousing 270 during the course of stent deployment induces the first lead screw 260 (and movement of the tubular enclosure coupled thereto) to axially translate a distance of approximately 15 to 25 centimeters relative to its position in the initial offset arrangement. Additionally, the handle assembly can be configured such that rotation of the housing during the course of stent deployment induces the second lead screw 262 (and movement of the associated end of the stent) to axially translate a distance of approximately 5 to 15 centimeters. For example, in one embodiment thesecond lead screw 262, which is in mechanical communication with an end of the stent, is configured to shorten the length of the stent (relative to the length of the stent in its elongated radially compressed configuration) by approximately 25% to 75% (e.g., approximately 50%). In other embodiments, the degree of change in the stent length pre-deployment to post-deployment can differ depending on the specific application. In other embodiments, rotation of thehousing 270 during stent deployment can cause thefirst lead screw 262 to axially translate more than 25 centimeters or less than 15 centimeters from its initial position, and cause thesecond lead screw 262 to axially translate more than 15 centimeters or less than 5 centimeters from its initial position. - In various embodiments, the first and second lead screws 260 and 262 can define additional mating features to facilitate mutual alignment. For example, one lead screw (e.g., the first lead screw 260) can define a longitudinal key or spline that slidingly engages with a longitudinal slot on the other lead screw (e.g., the second lead screw 262) such that the lead screws maintain longitudinal alignment with each other as the lead screws longitudinally translate past one another. In other embodiments, one or both lead screws can include other suitable alignment features.
- The first and second lead screws 260 and 262 can be made of injection molded plastic of suitable column strength and overall torsional rigidity to bear axial loads and/or torsional loads during stent deployment. In other embodiments, the lead screws 260, 262 can additionally or alternatively include other suitable materials that are milled, turned, casted, and/or formed in any suitable manufacturing process to create the threads and other associated features of the lead screws 260, 262. The lead screws 260, 262 can additionally or alternatively meet predetermined load requirements by including particular thread types (e.g., acme threads or other trapezoidal thread forms) and/or material reinforcements. In some embodiments, the plastic material is of a formulation including a lubricant for low-friction thread engagement, such as LUBRILOY® D2000. Furthermore, suitable external lubricants can additionally or alternatively be applied to the lead screws 260, 262 to help ensure smooth engagement of the threads.
- As shown in
FIGS. 5A-12D , in various embodiments of the handle assembly, the housing can include a stationary portion and rotatable shaft portion. As shown inFIG. 5A , for example, thehousing 270 can include a first orrotatable shaft portion 252 a and a second orstationary portion 252 b coupled to one another and secured by alocking collar 254. Though thefirst shaft portion 252 a is referred to herein as the “rotatable shaft portion 252 a” of thehousing 270 and thesecond shaft portion 252 b is referred to as the “stationary shaft portion 252 b”, it should be understood that in other embodiments either the first orsecond shaft portion other shaft portion FIG. 5B , therotatable shaft portion 252 a can define housing the first andsecond housing threads lead screws rotatable shaft portion 252 a relative to thestationary shaft portion 252 b can cause the first andsecond threads lead screws housing 270 can define thethreads FIG. 11A illustrates another embodiment in which the housing 470 includes a first orrotatable shaft portion 452 a and a second orstationary portion 452 b that are coupled to one another and secured by alocking collar 454. - In some embodiments, as shown in
FIG. 5B , thehousing 270 defines internal threads configured to engage with the externally threaded lead screws 260, 262 (FIG. 5A ). In other embodiments, thehousing 270 can define external threads configured to engage with internally threaded lead screws. In some embodiments, as shown inFIGS. 5A and 5B , thestationary shaft portion 252 b (or another suitable part of housing 270) can include one or more keyway splines 279 (FIG. 5B ), and/or any other suitable key mechanism. Eachkeyway spline 279 can engage a respective axial groove 269 (FIG. 5A ) in one of the lead screws 260, 262 to prevent rotation of the lead screws 260, 262 when therotatable shaft portion 252 a rotates, thereby substantially constraining the lead screws 260, 262 to axial translation only. - The
housing 270 can include shell pieces that mate and couple to one another to form thestationary shaft portion 252 b and therotatable shaft portion 252 a. The shell pieces can define keys and/or other interlocking or alignment features to properly mate and form a volume or enclosure that is configured to house or otherwise contain the first and second lead screws 260 and 262 and/or other catheter components. The shell pieces can be snap fit together, attached by screws and/or other mechanical fasteners, and/or otherwise joined. Similar to the first and second lead screws 260 and 262, the portions of thehousing 270 can be composed of a suitable rigid plastic formed by injection molding. In other embodiments, thehousing 270 can additionally or alternatively include any other suitable materials and/or be formed by casting, turning, milling, and/or any other suitable manufacturing process. In various embodiments, thehousing 270 can be made of a lubricious plastic material and/or coated with external lubricant to facilitate smooth thread engagement with the lead screws 260, 262 and relative rotation between the rotating andstationary shaft portions housing 270. -
FIGS. 6A-6E show an embodiment of thehandle assembly 250 with the first and second lead screws 260 and 262. In this embodiment, thehandle assembly 250 is configured to deploy, from theouter sheath 224 or other tubular enclosure, a distal end of the stent (not shown) before the proximal end of the stent during stent delivery. By deploying the distal end of the stent first and maintaining the axial position of the exposed distal end of the stent, thehandle assembly 250 enables accurate and precise positioning of the distal end of the stent. This functionality can be useful for applications where accurate and precise placement of the distal end of the stent is clinically necessary. For example, then the aorta is accessed through the femoral artery (as is typical of EVAR procedures for AAA repair), this embodiment ofhandle assembly 250 can be used to deploy a stent graft in a known region of healthy aortic tissue that is superior to an aortic aneurysm but inferior to a renal artery. Precise superior positioning of the distal end of the stent is expected to increase (e.g., maximize) coverage of and sealing to healthy aortic neck tissue without blocking blood flow into the renal artery. In other embodiments, thehandle assembly 250 may be used in various other applications that require or benefit from accurate placement of a distal end of the stent (with respect to the handle operator) 1. - In the embodiment shown in
FIGS. 6A-6E , thefirst lead screw 260 is directly or indirectly coupled to a tubular enclosure that can translate in a proximal direction to expose the stent. For example, as shown inFIGS. 6A and 6B , thefirst lead screw 260 can be coupled toouter sheath 224 of the delivery catheter such that translation of thefirst lead screw 260 actuates corresponding translation of theouter sheath 224. In certain embodiments, thefirst lead screw 260 can be coupled to adistal coupler 242, which is in turn coupled to theouter sheath 224 such that proximal and distal movement of thefirst lead screw 260 corresponds to proximal and distal movement of theouter sheath 224. For instance, sufficient proximal movement of thefirst lead screw 260 anddistal coupler 242 will cause theouter sheath 224 to move proximally enough to expose the distal portion of the stent, thereby allowing the exposed portion of the stent to expand. Alternatively, the coupling between thefirst lead screw 260 and theouter sheath 224 can include any suitable mechanical communication between thefirst lead screw 260 and a tubular enclosure housing a stent. For example, thefirst lead screw 260 can be coupled directly to the tubular enclosure, coupled to a push or pull tube, a wire, and/or another suitable mechanism that is in turn coupled to the tubular enclosure. Thefirst lead screw 260 can be coupled to thedistal coupler 242 and/or other coupling epoxy, snap fit coupler designs, and/or any suitable mechanical fasteners. However, the coupling can additionally or alternatively include any suitable kind of coupling that effectuates movement of the tubular enclosure. - As shown in
FIGS. 6A-6E , thesecond lead screw 262 can be directly or indirectly coupled to a proximal end of the stent (not shown) such that translation of thesecond lead screw 262 actuates corresponding translation of the proximal end of the stent. As shown inFIG. 6D , thesecond lead screw 262 is configurable to be mechanical communication with aproximal coupler 240 that is coupled todilator 236, which is in turn coupled to the proximal end of the stent (e.g., as shown inFIG. 2C ). For example, thesecond lead screw 262 can have acoupler engagement surface 264 in the same longitudinal path as theproximal coupler 240 such that when secondlead screw 262 moves a sufficient distance in a distal direction, thecoupler engagement surface 264 will abut theproximal coupler 240. After this engagement occurs, distal movement of thesecond lead screw 262 will cause corresponding distal advancement of theproximal coupler 240, thedilator 236, and the proximal end of the stent. Alternatively, the coupling between thesecond lead screw 262 and the proximal end of the stent (or other suitable stent portion) can include any suitable mechanical communication, such as those described above regarding the coupling between thefirst lead screw 260 and the outer sheath. - The
handle assembly 250 can further include a stent compressor in mechanical communication with a first portion (e.g., a distal portion) of the stent and independently movable relative to a second portion of the stent such that movement of the stent compressor is independent of the lead screws 260, 262 and corresponds to axial compression and radial expansion of the stent. In the embodiment illustrated inFIG. 6E , for example, the stent compressor is defined by anaxial compression slider 280 that is in mechanical communication with the distal end of the stent independent of the first and second lead screws 260 and 262. In other embodiments, thehandle assembly 250 can include Theaxial compression slider 280 can be configured to axially compress the stent to facilitate positioning and longitudinal and rotational orientation. In particular, after the stent has been partially exposed and the exposed portion of the stent is able to radially expand, longitudinal proximal movement of theaxial compression slider 280 can cause radial expansion and/or supplement self-expansion of the exposed portion of stent. In this manner, a practitioner can partially deploy the stent in a “jackhammer” type motion to compress the braided stent, reposition the stent as necessary to best interface with the vasculature (e.g., achieve opposition between the vessel wall and stent graft to form or confirm a seal) and/or other adjacent device components, and then fully deploy the stent by allowing the stent to self-expand (or supplementing radial expansion with the axial compression slider 280) without constraint by the outer sheath, top cap, and/or distal collet. Furthermore, the practitioner can make adjustments by manipulating theaxial compression slider 280 in a stent tensioning direction, thereby radially compressing the stent again to allow for repositioning of the stent. - In one embodiment, the
axial compression slider 280 is configured to expand the stent from a first radius when in its radially compressed configuration to a deployment radius that is sufficiently large to form an at least substantially fluid-tight seal against the vessel in which the stent is being deployed. For example, theaxial compression slider 280 can be configured to expand from a smaller first radius to a larger deployment radius, where the deployment radius is between approximately three and five times the first radius (e.g., at least four times the first radius). However, in other embodiments the expansion ratio, or other relative change in cross-sectional stent dimension (e.g., diameter), can depend on the specific application. - Referring to
FIG. 6C , the axial compression slider 280 (FIG. 6E ) can engage adistal bearing assembly 282, which is coupled to aninner shaft 232 by epoxy or any suitable fastening means. Theinner shaft 232 can be in mechanical communication with the distal end of stent. Longitudinal movement of thecompression slider 280 can correspond to longitudinal movement of thedistal bearing assembly 282. Thedistal bearing assembly 282 can ride within one ormore slots 274 on opposite sides of the handle housing 270 (FIG. 6A ), and this longitudinal movement of the bearingassembly 282 can correspond to longitudinal movement of the distal end of the stent. In various embodiments, (e.g., when the proximal end of the stent is substantially stationary), proximal movement of theslider 280 will proximally pull the distal end of the stent so that the stent is in an axially compressed, radially expanded state. Similarly, distal movement of theslider 280 after some stent compression will distally extend the distal end of the stent so the stent is in a tensioned, radially constrained state, thereby allowing the practitioner to reposition the subsequently constrained stent relative to the vasculature. As shown inFIG. 6E , theaxial compression slider 280 can include alocking tab 284 that selectively engages with one or more notches 272 (FIGS. 6A and 6C ) and/or other types of locking portions on the handle of thehousing 270. Engagement of thelocking tab 284 with one of thenotches 272 enables the operator to fix longitudinal position of the partially expanded/deployed stent in anticipation of full deployment. When thelocking tab 284 is disengaged from thenotches 272, such as by a depression of a lever or button by the device operator, theslider 280 is free to longitudinally move and axially compress the stent. When thelocking tab 284 is engaged with one of thenotches 272, the longitudinal position of theslider 280 is set. In various embodiments, the set ofnotches 272 can correspond to discrete degree of stent compression that the operator can use to gauge stent deployment. In other embodiments, thehandle assembly 250 can include any suitable locking mechanism for securing the longitudinal position ofslider 280. - Other variations of the
handle assembly 250 can include other mechanisms for facilitating axial stent compression independently of the first and second lead screws 260 and 262. For example, the embodiment ofFIGS. 8A and 8B includes anaxial compression slider 380 and/or other stent compressor that can be used to rotationally and longitudinally manipulate a compression coupler 384, which is coupled to the inner shaft by epoxy and/or any suitable fastening means. Similar to theslider 280 described above with reference toFIGS. 6A-6E , longitudinal translation of theslider 380 corresponds, through mechanical communication, to longitudinal movement of the distal end portion of a stent for selective and reversible axial compression of the stent. As shown inFIG. 8B , the longitudinal position of theslider 380 can be locked by rotating theslider 380 so that the coupler 384 engages one of the plurality of slider lock notches 382 in the handle housing. As another example, the embodiment ofFIG. 9 includes acompression lead screw 380′ coupled to the inner shaft by epoxy or any suitable fastening means. Rotation of thecompression lead screw 380′ will result in its longitudinal translation and corresponding longitudinal motion of the inner shaft and distal end portion of the stent for selective and reversible axial compression of the stent. - Referring back to
FIGS. 6A-6E , thehandle assembly 250 embodiment can further include a top cap slider 290 (FIG. 6E ) that is configured to distally move thetop cap 222. Thetop cap slider 290 can engage a proximal bearing assembly 292 (FIG. 6C ), which is coupled to thetip tube 230 by epoxy or any suitable fastening means. Like thedistal bearing assembly 282, theproximal bearing assembly 292 can ride along one ormore slots 274 on opposite sides of the handle housing during its longitudinal movement. Becausetip tube 230 is in mechanical communication with thetop cap 222, longitudinal movement of thetop cap slider 290 corresponds to longitudinal movement of thetop cap 222. In particular, sufficient distal movement of thetop cap slider 290 can completely expose a distal end portion of the stent. As shown inFIG. 6E , thetop cap slider 290 can be selectively coupled to theaxial compression slider 280 by means of aremovable slider collar 294. When theslider collar 294 is coupled to both thecompression slider 280 and the top cap slider 290 (e.g., with a snap fit or fasteners) thecompression slider 280 and thetop cap slider 290 can move in tandem. When theslider collar 294 is removed, thecompression slider 280 and thetop cap slider 290 are movable independent of one another. In some embodiments, thetop cap slider 290 can also be locked directly to thecompression slider 280 by a snap fit and/or other suitable fasteners (e.g., after theslider collar 294 is removed). An alternative embodiment of thetop cap slider 290 is shown inFIGS. 10A and 10B , in which thetop cap slider 290 is positioned on the proximal end portion of the housing and engagesproximal bearing assembly 292 in a manner similar to that described above. - Other variations of the
handle assembly 250 can include other mechanisms for moving a top cap. For example, the embodiment ofFIGS. 8A and 8B includes atip release screw 390. When turned, thetip release screw 390 can move distally and cause the top cap to move distally and release the distal end portion of the stent. The threads of thetip release screw 390 can prevent accidental deployment as the result of pushing axially on the head of thetip release screw 390. As another example, the embodiment ofFIG. 9 includes atip release pusher 390′. When pushed in a distal direction, thetip release pusher 390′ moves distally and causes the top cap to move distally and release the distal end portion of the stent. In these and other embodiments, additional locks and/or other safety mechanisms (e.g., collars, mechanical fasteners, mechanical keys, etc.) can be removeably coupled to the mechanisms for moving the top cap to reduce the likelihood of accidental or premature deployment of the top cap. -
FIGS. 11A-12D show another embodiment of thehandle assembly 450 with the first and second lead screws 460 and 462. In this embodiment, thehandle assembly 450 is configured to deploy, from a tubular enclosure 420 (FIG. 11A ), aproximal end portion 410 p of thestent 410 before thedistal end portion 410 d of thestent 410 during a “reverse deployment” stent delivery. By deploying theproximal end portion 410 p of thestent 410 first and maintaining the axial position of the exposed proximal end of thestent 410, thehandle assembly 450 can facilitate accurate and precise positioning of theproximal end portion 410 p of thestent 410. This functionality can be useful for applications in which it is important to align the proximal end of thestent 410 correctly. For example, assuming an approach through the femoral artery typical of EVAR procedures for AAA repair, this embodiment can be used to deploy a stent graft in an iliac artery for overlapping and sealing with an implanted aortic stent as it may be desirable to ensure that (1) adequate stent length will be deployed in the iliac artery, and/or (2) no vessels branching from the iliac artery (e.g., the hypogastric artery) are inadvertently blocked. In other embodiments, thehandle assembly 450 may be used in other applications that benefit from accurate and precise placement of a proximal end of the stent. - In the embodiment of the
handle assembly 450 shown inFIGS. 11A-12D , thefirst lead screw 460 can be directly or indirectly coupled to a tubular enclosure that can travel in a distal direction to expose the stent. For example, thefirst lead screw 460 can be in mechanical communication with thetop cap 424 of the delivery catheter such that distal translation of thefirst lead screw 460 actuates corresponding distal translation of thetop cap 424. As shown inFIG. 12D , thefirst lead screw 460 can be coupled to aproximal coupler 440, which is in turn coupled to thetip tube 430, and thetip tube 430 is coupled to thetop cap 424. In particular, sufficient distal movement of thefirst lead screw 460 and theproximal coupler 440 will cause the top cap 424 (and/or any outer sheath attached to and extending thetop cap 424 along the stent) to move distally enough to expose the proximal end portion of the stent, and additional distal motion of thefirst lead screw 460 will eventually causetop cap 424 to release the entire length of the stent, thereby allowing the stent to self-expand. Alternatively, the coupling between thefirst lead screw 460 and thetop cap 424 can include any other suitable mechanical communication between thefirst lead screw 460 and thetop cap 424, such as the direct or indirect methods described above with respect to the embodiment ofFIGS. 6A-6E . In further embodiments, the coupling can additionally or alternatively include any suitable kind of coupling that effectuates movement of the distaltop cap 424. - In the embodiment of the
handle assembly 450 shown inFIGS. 11A-12D , thesecond lead screw 462 is directly or indirectly coupled to adistal end portion 410 d of thestent 410 such that translation of thesecond lead screw 462 actuates corresponding translation of thedistal end portion 410 d of thestent 410. Thesecond lead screw 462 can be configured to be in mechanical communication with the distal coupler 442 (FIG. 12C ), which is coupled to the inner shaft 432, and the inner shaft 432 is engaged with thedistal end portion 410 d of thestent 410 by the leadingcollet 428. More particularly, as shown inFIG. 12C , thesecond lead screw 462 has acoupler engagement surface 464 moving within aneck 444 of thedistal coupler 442 such that when secondlead screw 462 moves proximally enough across theneck 444, thecoupler engagement surface 464 will abut and engage thedistal coupler 442. After this engagement occurs, additional proximal movement of thesecond lead screw 462 will cause corresponding proximal advancement of thedistal coupler 442, the inner shaft 432, and thedistal end portion 410 d of thestent 410. Alternatively, the coupling between thesecond lead screw 462 and thedistal end portion 410 d of the stent 410 (or any suitable stent portion) can include any suitable mechanical communication. -
FIG. 13 is a partially transparent, isometric view of a portion of ahandle assembly 550 configured in accordance with another embodiment of the technology. Thehandle assembly 550 can include afirst lead screw 560 having a first pitch and asecond lead screw 562 having a second pitch different from the first pitch. Similar to the handle assemblies in the embodiments described above, one of the lead screws 560 or 562 is in mechanical communication with a tubular enclosure surrounding a stent, and the otherlead screw shaft 564 such that a clockwise or counterclockwise rotation of theshaft 564 will cause the lead screws 560, 562 to axially translate in opposite directions. In some variations,second lead screw 562 can be internally threaded with a thread corresponding to the pitch and handedness of firstlead screw 560, such that thefirst lead screw 560 can pass longitudinally within thesecond lead screw 562 as the lead screws 560, 562 axially translate. -
FIG. 14 illustrates ahandle assembly 650 configured in accordance with yet another embodiment of the technology. Thehandle assembly 650 can include a series of coaxial, nested first andsecond racks second pinions racks pinions racks other rack handle assembly 650 ofFIG. 14 can include different actuation inputs that induce opposing movement of theracks first pinion 670 or thesecond pinion 672 by a handle component (not shown) will effectuate the simultaneous longitudinal translations of the first andsecond racks first rack 660 or thesecond rack 662 by a handle component (not shown) will be translated through the gearing to effectuate the simultaneous longitudinal translation of theother rack racks pinions racks pinions handle assembly 650 can include suitable additional features, and/or have a different suitable gearing configuration. - In some embodiments, the handle assemblies described above can include a delay system that delays the synchronized actions of exposing a stent and axially compressing the stent until after a portion of the stent is exposed. In particular, in some variations, the delay system delays mechanical communication between a moving position compensating element and the stent until a predetermined portion of the stent is exposed from a tubular enclosure. In other variations, the delay system delays movement of the position compensating element until a predetermined portion of the stent is exposed from the tubular enclosure. The delay can be based on, for example, the distance that the tubular enclosure must travel before beginning to expose the stent. The delay system can accordingly avoid premature radial expansion of the stent within the tubular enclosure.
-
FIG. 6D illustrates one embodiment of a delay system in which there is a spatial longitudinal offset between theproximal coupler 240 and thecoupler engagement surface 264 of thesecond lead screw 262. The longitudinal offset corresponds to a predetermined delay distance. Upon rotation of the shaft portion of the handle assembly, both the first and second lead screws 260 and 262 begin to move in opposite directions, but because of the longitudinal offset between thecoupler engagement surface 264 of thesecond lead screw 262 and theproximal coupler 240, thecoupler engagement surface 264 does not abut theproximal coupler 240 until thesecond lead screw 262 has traversed the offset. In other words, rotation of the handle actuates both leadscrews coupler engagement surface 264 has traversed the predetermined delay distance, rotation of the handle can result in translation of firstlead screw 260 to partially expose the stent without resulting in axial compression of the stent. -
FIG. 12C illustrates another embodiment of a delay system in which thedistal coupler 442 with theneck 444 is responsible for a delay in synchronization, where the length of theneck 444 is equal to a predetermined delay distance. Upon rotation of the shaft portion of thehandle assembly 450, both the first and second lead screws 460 and 462 begin to move in opposite directions, but because of theneck 444 ofdistal coupler 442, thecoupler engagement surface 464 of thesecond lead screw 462 does not abut the shoulder of thedistal coupler 442 until thesecond lead screw 462 has traversed theneck 444. In other words, similar to the embodiment ofFIG. 6D , rotation of portions of thehandle assembly 450 actuates both leadscrews coupler engagement surface 464 has traversed the predetermined delay distance across thecoupler neck 444, rotation of the handle can result in translation of thefirst lead screw 460 to partially expose the stent, without resulting in axial compression of the stent. - In other embodiments of delay systems, the proximal or distal coupler can be in a reverse configuration with respect to the uncovering element and the position compensating element, and/or the delay system can include other components to facilitate a delay. Furthermore, in some embodiments, the handle assembly does not include a delay system to delay axial compression of the stent. In an auto-compression embodiment, the simultaneous actions of exposing the stent and axially compressing the stent can be carefully synchronized (e.g., with no delay of either action) with relative rates appropriate so that a suitable amount of axial compression is performed at the same time the stent is initially exposed.
- In some embodiments, the housing can include a mechanism that operates additionally or alternatively to the axial compression slider 280 (
FIG. 6E ) and radially compresses the stent diameter after partial deployment. For example, as shown inFIGS. 10A and 10B , the handle assembly can include arepositioning ring 281 that, when moved longitudinally along the axis of the housing, can be used to reduce the outer profile of a stent that has been axially compressed to a radially expanded state (e.g., by simultaneous auto-compression as described above, or by an independent axially compressing component). Therepositioning ring 281 can be in mechanical communication with an end portion of the stent by a push or pull tube such that proximal or distal movement of therepositioning ring 281 causes corresponding movement of an end of the stent, thereby extending and radially contracting the stent. - As another example, the stent can be undeployed by backdriving the shaft portion of the handle, rotating the shaft portion in a direction opposite the direction required for deployment, such as to reverse the paths of the lead screws. In this reverse deployment, the stent becomes elongated and radially compressed, and the sheath recovers the exposed portion of the stent. Once the stent returns to its radially compressed state, the device operator can reposition the stent relative to the surrounding environment.
- As shown in
FIG. 15A , in some embodiments the housing further includes arotational control mechanism 350 that limits rotation of the shaft portion to rotation in a deployment direction (i.e., the direction that actuates stent deployment). In preventing the rotation of the shaft portion in the direction opposite the deployment direction, therotational control mechanism 350 can prevent axial compression of the stent when the stent is still radially constrained in the tubular enclosure, as well as selectively lock against reverse deployment while stent deployment is in progress. In some embodiments, therotational control mechanism 350 can be selectively disengaged so as to selectively permit rotation in the direction opposite the deployment direction, such as to permit reverse deployment. When therotational control mechanism 350 is disengaged, the shaft portion can be rotated in the direction opposite the deployment direction in order to reconstrain the stent within the tubular enclosure. By permitting reverse deployment, the handle assembly can allow repositioning of the entire stent even after the stent has been partially deployed, if so desired. - As shown in
FIGS. 15A-15C , a locking collar can define at least onechannel 352 and the rotatable shaft portion can define at least onespring tab 354. As long as therotational control mechanism 350 is engaged, thespring tab 354 flexes to accommodate rotation of the shaft portion in the deployment direction, but thespring tab 354 engages and stops against thechannel 352 when the shaft portion is rotated in the direction opposite of the deployment direction. When thespring tab 354 stops against thechannel 352, tactile and/or audio clicking feedback can inform the handle operator that he or she has rotated the shaft in an impermissible direction. The locking collar can include multiple channels 352 (e.g., fourchannels 352 equally circumferentially distributed around the collar), such that asingle spring tab 354 on the shaft portion permits no more than ninety degrees of rotation in the non-deployment direction. However, in other embodiments therotational control mechanism 350 can include any suitable number ofchannels 352 and/orspring tabs 354. Disengagement of therotational control mechanism 350 can be performed, for example, by sliding the locking collar distally or proximally out of the rotational path of thespring tab 354. For example, as shown inFIG. 15C , moving the locking collar both rotationally and longitudinally to navigate a key 358 on the shaft portion through aguide path slot 356 in the locking collar will permit the locking collar to be oriented in a manner where thespring tab 354 will not engage withchannel 352. Alternatively, the locking collar can be completely removed to disengage therotational control mechanism 350. Furthermore, the housing can additionally or alternatively include other suitable features for selectively restraining rotation of the shaft portion to one direction. - In some embodiments, the housing additionally or alternatively includes other control mechanisms that selectively prevent rotation in a deployment direction. For example, the housing can include an additional or alternative rotational control mechanisms that prevent rotation of the shaft portion in the deployment direction until intentional steps are taken to disengage the rotational control mechanism, such as to prevent premature deployment of the stent (e.g., when the delivery catheter is not yet at the target area).
- In further embodiments, the handle assembly can include one or more points of entry for contrast fluid. For example, as shown in
FIG. 7 , thedistal coupler 242 can be coupled to contrast tubing 244 to facilitate injection of contrast fluid through the delivery catheter to the stent region. The injected contrast fluid aids in imaging the target area surrounding the stent for purposes of advancing the delivery catheter and positioning and aligning the stent during deployment. Thedistal coupler 242 can include fluid-tight seal 246 that prevents contrast fluid and/or recirculating blood from entering the handle assembly. The fluid-tight seal 246 can include, for example, one or more o-rings. In other embodiments, thedistal coupler 242 can additionally or alternatively include other suitable sealing features. Since in these embodiments thedistal coupler 242 andsealing mechanism 246 may be in contact with recirculating blood, thedistal coupler 242 andsealing mechanism 246 can be made of any suitable biocompatible material. In other examples, other proximal and/or distal couplers in handle assembly can be coupled to contrast tubing, and/or the handle assembly can include other fluid-tight couplers as appropriate. Furthermore, the couplers for introducing couplers can define a circular, annular space or other suitable non-circular shapes. - In various embodiments, a method for implanting a stent graft at a target area for treatment of an aneurysm includes: advancing, toward the target area, a catheter comprising a tubular enclosure covering the stent graft; positioning the stent graft proximate to the target area; deploying the stent graft; allowing the stent graft to anchor in or at the target area; and withdrawing the catheter from the target area. Deploying the stent graft can include effectuating simultaneous, opposing translations of first and second handle components such that the first the handle component longitudinally displaces the tubular enclosure in a first direction, and the second handle component axially compresses the stent graft in a second direction opposite the first direction. The method is described further with reference to particular handle assemblies shown in
FIGS. 16A-18E , but the method is not limited to use of the handle assemblies described herein. Furthermore, though the method is primarily described in regards to deploying a specific design of stent graft, it should be understood that the method can similarly be used to deploy other kinds of stent grafts or endografts, a bare stent, or any suitable kind of stent. - Various aspects of advancing the catheter, positioning the stent graft, allowing the stent graft to anchor in the target area, and withdrawing the catheter can be similar to those steps described in U.S. Patent Application Publication No. 2011/0130824, which is incorporated herein by reference in its entirety. For example, advancing the catheter can involve entry into a blood vessel using a percutaneous technique such as the well-known Seldinger technique.
- With respect to deploying the stent graft, in one embodiment of the method, a practitioner or device operator can displace the tubular enclosure in a proximal direction to expose only a portion of the stent graft, constrain a distal endpoint of the stent graft in a radially compressed state, and axially compress the stent graft to radially expand only the exposed portion of the stent graft. For example, the device operator can initially rotate a shaft portion of handle to move the
outer sheath 724 and expose a portion of the stent graft 710 (e.g., 2-3 inches). A delay system can stall any stent graft compression resulting from this initial rotation, though in other embodiments some amount of stent graft compression can automatically occur during this initial rotation. Thetop cap 722 can still constrain the distal end of the stent graft after this initial handle rotation. Proximal movement of an axial compression slider, which is coupled to the distal end of thestent graft 710 d by leadingcollet 728, pulls leadingcollet 728 and distalstent graft end 710 d proximally, which axially compresses and radially expands the exposed portion of the stent graft, as shown inFIG. 16A . During this time, the practitioner can view, through imaging methods and/or use contrast fluids and radiopaque markers, the rotational and longitudinal orientation of the exposed stent graft. - If not satisfied with the position and alignment of the stent graft, the device operator can radially collapse the stent graft down to an outer profile small enough for stent graft repositioning. In particular, distal movement of the axial compression slider pushes leading
collet 728 and distalstent graft end 710 d distally, which tensions and radially collapses the exposed portion of the stent graft to a degree suitable for repositioning. The repositioning process can repeat until the practitioner is satisfied. In some embodiments, the method can additionally or alternatively include resheathing the exposed stent graft with the tubular enclosure. For example, the device operator can rotate (backdrive) the shaft portion of the handle in the direction opposite that for actuating deployment, in order to reposition the sheath over the previously exposed portion of the stent graft. - When satisfied with the position and alignment of the stent graft, the device operator can release the distal end of the stent graft from its radially compressed state. For example, the device operator can move a tip slider in a distal direction to remove the
top cap 722 from the stent graft, thereby releasing the distal end of the stent graft, as shown inFIG. 16B . However, the method can involve other actuation means, such as rotating a tip screw, to remove the top cap or other appropriate enclosure. - Once the distal end of the stent graft is released, the device operator can simultaneously further expose the stent graft by displacing the tubular enclosure and axially compress the stent graft by advancing the unexposed proximal end of the stent graft as the tubular enclosure is displaced, thereby compensating for stent graft foreshortening. For example, shown in
FIG. 16B , the device operator can manipulate the handle to induce opposing translations of first and second handle components, where one handle component longitudinally displaces the tubular enclosure (e.g., outer sheath 224) in a proximal direction while the other handle component axially compresses the stent graft with a distally-directed force (advancing a proximal end of thestent graft 710 d via trailing collet 226). - With respect to deploying the stent graft, in another embodiment of the method shown in
FIG. 17 , in a reverse deployment scenario, the device operator manipulates the handle to induce opposing translations of first and second handle components, where one handle component longitudinally displaces the tubular enclosure (e.g.,top cap 824 via tip tube 830) in a distal direction while the other handle component axially compresses thestent graft 810 with a proximally-directed force (e.g., retracting a distal end of thestent graft 810 d via leadingcollet 828 and inner shaft 832). -
FIGS. 18A-18E show an exemplary embodiment of the method used specifically to deliver stent graft grafts for treatment of an abdominal aortic aneurysm. In this specific application of the method, the method deploys stent grafts with D-shaped cross-sections as described in U.S. Patent Application Publication No. 2011/0130824, where the flat portions of the D-shaped stent grafts press against each other to form a straight septum and the curved portions of the D-shaped stent grafts press against the aortic wall to form a seal against the aortic wall. The figures show and are described with reference to the delivery device embodiment ofFIG. 6A , but it should be understood that any suitable embodiments and variations of the device can similarly be used in the method. Furthermore,FIGS. 18A-18E show and are generally described with respect to the operations of handle of only one delivery device, which is typically identical to the delivery device used for deploying the depicted contralateral stent graft. - In
FIG. 18A ,stent grafts 910 are positioned superior to the aneurysm and partially unsheathed. The catheters of two instances of the delivery system have been advanced toward the target area in an aorta using various techniques, such as over-the-wire (guidewires not shown), with a first catheter advanced along the left iliac artery, and a second catheter advanced along the right iliac artery. The catheters have been advanced until thetop caps 922 andstent grafts 910 are positioned superior to the aneurysm, where radiopaque markers can aid correct placement of the stent grafts. In one embodiment, the catheters cross paths within the aneurysm such that the distal end of each catheter approach and/or touch the side of the aortic wall that is opposite the side of entry. In other words, the crossing of catheters may induce astent graft 910 passing through the aneurysm from the left iliac artery to appose the right side of the aortic wall, and astent graft 910 entering from the right iliac artery to appose the left side of the aortic wall. On each delivery device, rotation ofhandle portion 952 a has caused internal threads ofhandle portion 952 a to simultaneously engage first and second lead screws 960 and 962, resulting in proximal translation of firstlead screw 960 and distal translation of secondlead screw 962. Proximal movement of firstlead screw 960 has causedouter sheath 924 to retract and expose a portion ofstent graft 910, thoughtop cap 922 still constrains the distal end ofstent graft 910. Meanwhile, in a delay system (not shown) as described above with respect toFIG. 6D , distally-travellinglead screw 962 has not traversed the predetermined delay distance, such thatlead screw 962 does not yet axially compress the exposedstent graft 910. - In
FIG. 18B , thestent grafts 910 are slightly axially compressed such that the exposed portions ofstent grafts 910 are slightly radially expanded. In particular, on each delivery device, the axial compression slider (represented by box 980), which is coupled todistal bearing assembly 982 in mechanical communication with the distal end ofstent graft 910, has been pulled proximally to axially compress the exposed portion ofstent graft 910. As described above, such axial compression induces and/or supplements the radial self-expansion of thestent graft 910. Since in each device, tip slider (represented by box 990) is coupled toaxial compression slider 980 byremovable slider collar 994,top cap 922 moves in tandem with the distal end of thestent graft 910. Additionally,axial compression slider 980 can optionally be moved distally to tension and radially collapse the exposed portion of thestent graft 910. - In other words, the longitudinal position of the
axial compression slider 980 corresponds to the degree of radial expansion, so the device operator can move theaxial compression slider 980 both proximally and distally to adjust the radial expansion and radial contraction, respectively, of thestent graft 910. Furthermore, the device operator can adjust the longitudinal position of the catheter as a whole by withdrawing and/or advancing the entire catheter, to adjust the longitudinal position of thestent grafts 910. Partial radial expansion of the stent grafts, when viewed under fluoroscopy by the device operator, aids optimal rotational and/or longitudinal positioning of thestent grafts 910, both relative to each other and relative to the aortic wall. - In particular, each partially deployed
stent graft 910 is longitudinally positioned such that its graft material is aligned with (just inferior to) a renal artery in order to maximize overlap between the anchoring bare stent portion ofstent graft 910 and healthy aortic neck tissue, without resulting in the graft material blocking blood flow to the renal arteries. Additionally, as shown inFIG. 18C , in instances in which thestent grafts 910 are being deployed in a patient having longitudinally offset renal arteries, thestent grafts 910 are optimally positioned with a corresponding longitudinal offset in order to accommodate the offset renal arteries without sacrificing coverage nor blocking blood flow to the renal arteries. - Furthermore, each partially deployed
stent graft 910 is rotationally oriented such that the flat portions of the D-shapedstent grafts 910 press against each other to form a straight septum and the curved portions of the D-shapedstent grafts 910 press against the aortic wall to form a seal against the aortic wall. - In
FIG. 18C , the stent grafts are longitudinally and rotationally oriented in the desired manner, and further proximal retraction ofaxial compression slider 980 has induced additional radial expansion of thestent graft 910 to causestent graft 910 to press against the aortic wall. The twostent grafts 910 in conjunction can be radially expanded to a have a deployment radius sufficiently large to form a complete seal between them, as well as with the aorta wall superior to the aneurysm. This seal can be verified or confirmed by introducing contrast fluid through the catheter (e.g., through contrast tubing in the handles) and viewing whether the expandedstent grafts 910 prevent contrast flow across the sealed region. Alternatively, other methods of contrast introduction can be performed to confirm the seal ofstent grafts 910 against each other and/or against the vessel wall. As described above with respect toFIGS. 6C and 6E ,axial compression slider 980 locks longitudinally in place with notches on the housing, in anticipation of full deployment of the stent grafts. - In
FIG. 18D , the distal ends ofstent grafts 910 are freed fromtop cap 922 and allowed to self-expand against each other and against the aortic wall. If thestent grafts 910 have barbs or other suitable anchoring mechanisms, the stent grafts have become anchored at their deployed position. On each delivery device,slider collar 994 has been removed to allowtip slider 990 to move independently ofaxial compression slider 980. Thetip slider 990 has been moved distally to causetop cap 922 to move correspondingly move distally and release the distal end of the stent graft. After the distal end of thestent graft 910 self-expands,slider 990 may couple directly toaxial slider 980. At this point during deployment, the device operator may choose to inject contrast fluid through one or both catheters, with contrast couplers described above, in order to verify quality of the seal formed between the stent grafts and with the aortic wall. - Following verification of position and seal, resumed rotation of the handle portion in each delivery device again effectuates the opposing longitudinal translations of the first and second lead screws 960 and 962. In particular, after the
second lead screw 962 traverses the predetermined delay distance, thefirst lead screw 960 continues to proximally retractouter sheath 924 and thesecond lead screw 962 distally advances the proximal end ofstent graft 910. - In
FIG. 18E , the catheters have been withdrawn from thestent grafts 910 following full deployment of the stent grafts. The two simultaneous actions of the lead screws 960 and 962 during deployment have compensated for the displacement effects of stent graft foreshortening that would otherwise occur, thereby ensuring that the distal ends ofstent grafts 910 maintain their respective positions during deployment. The stent grafts ofFIG. 18E are shown with inferior ends terminating within the aneurysm. However, in other embodiments, each stent graft can extend into and anchor with a respective iliac artery. For example, the inferior graft end of thestent grafts 910 can terminate in the common iliac arteries immediately superior to the internal iliac arteries so as not to block blood flow to the internal iliac arteries. However, thestent grafts 910 can be positioned in any suitable manner. -
FIGS. 19A-19C show another exemplary embodiment of the method, extending that described with respect to 18A-18E. This specific application of the method deploysiliac stent grafts 1010, each of which couples to and extends arespective stent graft 910 deployed as described above. The figures show and are described with reference to the delivery device embodiment ofFIG. 12A , but it should be understood that any suitable embodiments and variations of the device can similarly be used in the method. Furthermore,FIGS. 19A-19C depict the operations of handle of only one delivery device, which is typically identical to the delivery device used for deploying the depicted contralateral stent graft. - In
FIG. 19A ,stent grafts 1010 are partially deployed adjacent to previously deployedstent grafts 910. The catheter of each delivery device was advanced over guidewires toward the aneurysm and into the lumen of acorresponding stent graft 910. The proximal graft end of eachstent graft 1010 was optimally aligned to be immediately superior to the internal iliac arteries, so as not to block the internal iliac arteries. However, thestent grafts 1010 can be positioned in any suitable manner. On each delivery device, rotation ofhandle portion 1052 a relative to handleportion 1052 b has caused internal threads ofhandle portion 1052 a to simultaneously engage first and second lead screws 1060 and 1062, resulting in distal translation offirst lead screw 1060 and proximal translation ofsecond lead screw 1062. Distal movement offirst lead screw 1060, which is in mechanical communication through tip tube 1030 totop cap 1024, has causedtop cap 1024 to advance distally and expose a portion ofstent graft 1010. The stent graft exposure began at the proximal end of the stent graft, which radially expanded off ofdocking tip 1026. Through a delay system (not shown) as described above with respect toFIG. 12C , proximally-travellinglead screw 1062 travels a predetermined delay distance before it becomes in mechanical communication with the distal end ofstent graft 1010 through inner shaft 1032. Once thelead screw 1062 has traversed the predetermined delay distance, its proximal translation axially compresses thestent graft 1010 by proximally retracting the distal end of thestent graft 1010. - In
FIG. 19B , thetop caps 1024, and/or associated outer sheath if present, have advanced distally enough to release the distal ends of thestent grafts 1010, thereby freeing the distal end of thestent graft 1010. The superior ends ofstent grafts 1010 are expanded within in the inferior ends ofstent grafts 910, such as to extend the lumens ofstent grafts 910 at a joining within the aneurysm. In other embodiments, thestent grafts 1010 can couple to thestent grafts 910 in any suitable location. At this point of deployment, the device operator may choose to inject contrast fluid through one or both catheters, using contrast couplers as described above, in order to verify quality of seal formed betweenstent grafts - In
FIG. 19C , the catheters have been withdrawn from thestent grafts 1010 following full deployment of the stent grafts. The two simultaneous actions of the lead screws 1060 and 1062 during deployment of compensated for the displacement effects of stent graft foreshortening that would otherwise occur, thereby ensuring that the proximal ends ofstent grafts 910 maintain their respective positions during deployment. - The handle assemblies and stent delivery methods shown and described herein offer several advantages over previous devices and stent delivery methods. For example, the handle assemblies provide for straightforward delivery of a stent graft to an artery while maintaining initial stent graft marker positions relative to a destination arterial wall. Embodiments employing opposing screws provide a user with the ability to deliver a stent graft at a high force with relatively little mechanical effort. This allows a user to exercise improved control over the delivery process, such as by enabling the user to control the outer diameter and/or length of the deployed stent. Further, the mechanisms disclosed herein provide effective push/pull motion while minimizing the number of parts, assembly time, and cost. The push/pull components move at relative rates according to the predetermined payout ratio (which, in the lead screw embodiment described above, is dependent on the difference in pitch between the lead screws), and determine the rate of stent deployment and degree of stent radial expansion. Such control over the rate of stent deployment and degree of stent radial expansion can allow the handle assemblies to maintain a low profile and minimize the overall bulk of the delivery device.
- From the foregoing, it will be appreciated that specific embodiments of the technology have been described herein for purposes of illustration, but that various modifications may be made without deviating from the disclosure. Certain aspects of the new technology described in the context of particular embodiments may be combined or eliminated in other embodiments. Additionally, while advantages associated with certain embodiments of the new technology have been described in the context of those embodiments, other embodiments may also exhibit such advantages, and not all embodiments need necessarily exhibit such advantages to fall within the scope of the technology. Accordingly, the disclosure and associated technology can encompass other embodiments not expressly shown or described herein.
Claims (15)
Priority Applications (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US13/964,015 US20140046429A1 (en) | 2012-08-10 | 2013-08-09 | Stent delivery systems and associated methods |
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US201261681907P | 2012-08-10 | 2012-08-10 | |
US201361799591P | 2013-03-15 | 2013-03-15 | |
US13/964,015 US20140046429A1 (en) | 2012-08-10 | 2013-08-09 | Stent delivery systems and associated methods |
Publications (1)
Publication Number | Publication Date |
---|---|
US20140046429A1 true US20140046429A1 (en) | 2014-02-13 |
Family
ID=50066773
Family Applications (3)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US13/963,912 Abandoned US20140052232A1 (en) | 2012-08-10 | 2013-08-09 | Handle assemblies for stent graft delivery systems and associated systems and methods |
US13/964,013 Active 2037-02-05 US10285833B2 (en) | 2012-08-10 | 2013-08-09 | Stent delivery systems and associated methods |
US13/964,015 Abandoned US20140046429A1 (en) | 2012-08-10 | 2013-08-09 | Stent delivery systems and associated methods |
Family Applications Before (2)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
US13/963,912 Abandoned US20140052232A1 (en) | 2012-08-10 | 2013-08-09 | Handle assemblies for stent graft delivery systems and associated systems and methods |
US13/964,013 Active 2037-02-05 US10285833B2 (en) | 2012-08-10 | 2013-08-09 | Stent delivery systems and associated methods |
Country Status (7)
Country | Link |
---|---|
US (3) | US20140052232A1 (en) |
EP (1) | EP2882381B1 (en) |
JP (1) | JP6326648B2 (en) |
CN (1) | CN105050549B (en) |
AU (1) | AU2013299425A1 (en) |
CA (1) | CA2881535A1 (en) |
WO (1) | WO2014026173A1 (en) |
Cited By (16)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US20100305686A1 (en) * | 2008-05-15 | 2010-12-02 | Cragg Andrew H | Low-profile modular abdominal aortic aneurysm graft |
US20110130819A1 (en) * | 2009-12-01 | 2011-06-02 | Altura Medical, Inc. | Modular endograft devices and associated systems and methods |
US20170172773A1 (en) * | 2014-05-21 | 2017-06-22 | Suzhou Innomed Medical Device Co., Ltd. | Highly retractable intravascular stent conveying system |
US9737426B2 (en) | 2013-03-15 | 2017-08-22 | Altura Medical, Inc. | Endograft device delivery systems and associated methods |
US20180221036A1 (en) * | 2014-01-10 | 2018-08-09 | Boston Scientific Scimed, Inc. | Retrieval devices and related methods of use |
US10285833B2 (en) | 2012-08-10 | 2019-05-14 | Lombard Medical Limited | Stent delivery systems and associated methods |
CN110121319A (en) * | 2017-10-31 | 2019-08-13 | 波顿医疗公司 | Distal side torque components, delivery system and its application method |
US10603198B2 (en) | 2016-09-09 | 2020-03-31 | Cook Medical Technologies Llc | Prosthesis deployment system and method |
US10751056B2 (en) | 2017-10-23 | 2020-08-25 | High Desert Radiology, P.C. | Methods and apparatus for percutaneous bypass graft |
WO2020212972A1 (en) * | 2019-04-14 | 2020-10-22 | Perflow Medical Ltd. | Adaptable device and method for bridging a neck of an aneurysm |
US11058566B2 (en) | 2018-04-11 | 2021-07-13 | Medtronic Vascular, Inc. | Variable rate prosthesis delivery system providing prosthesis alterations |
US11622858B2 (en) * | 2019-10-09 | 2023-04-11 | Medtronic CV Luxembourg S.a.r.l. | Valve delivery system including foreshortening compensator for improved positioning accuracy |
WO2023107926A1 (en) * | 2021-12-08 | 2023-06-15 | Silk Road Medical, Inc. | Delivery systems for endoluminal prostheses and methods of use |
US11730584B2 (en) | 2017-02-24 | 2023-08-22 | Bolton Medical, Inc. | System and method to radially constrict a stent graft |
US11744722B2 (en) | 2017-02-24 | 2023-09-05 | Bolton Medical, Inc. | Method of use for delivery system for radially constricting a stent graft |
CN116942252A (en) * | 2023-09-20 | 2023-10-27 | 杭州亿科医疗科技有限公司 | Bolt taking device and bolt taking system |
Families Citing this family (62)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US11259945B2 (en) | 2003-09-03 | 2022-03-01 | Bolton Medical, Inc. | Dual capture device for stent graft delivery system and method for capturing a stent graft |
CN102076281B (en) | 2008-06-30 | 2014-11-05 | 波顿医疗公司 | Abdominal aortic aneurysms: systems and methods of use |
US9724223B2 (en) * | 2011-05-27 | 2017-08-08 | Abbotcardiovascular Systems Inc. | Delivery system for a self expanding stent |
CN106420107B (en) | 2011-11-16 | 2019-02-05 | 波顿医疗公司 | The device and method of reparation for aortic branch blood vessel |
CA3095731C (en) | 2011-12-06 | 2023-02-07 | Aortic Innovations Llc | Device for endovascular aortic repair and method of using the same |
US9439751B2 (en) | 2013-03-15 | 2016-09-13 | Bolton Medical, Inc. | Hemostasis valve and delivery systems |
US9486350B2 (en) * | 2014-03-31 | 2016-11-08 | Medtronic Vascular, Inc. | Stent-graft delivery system having handle mechanism for two-stage tip release |
ES2731434T3 (en) | 2014-09-23 | 2019-11-15 | Bolton Medical Inc | Vascular repair devices |
US20160120677A1 (en) * | 2014-11-03 | 2016-05-05 | Flexible Stenting Solutions, Inc. | METHOD AND SYSTEM FOR CONTROLLED STENT DEPLOYMENT and RECONSTRAINT |
US10639181B2 (en) | 2014-11-04 | 2020-05-05 | Abbott Cardiovascular Systems Inc. | Methods and systems for delivering an implant |
US10433994B2 (en) | 2014-11-04 | 2019-10-08 | Abbott Cardiovascular Systems Inc. | Methods and systems for delivering an implant |
KR102501552B1 (en) | 2015-01-11 | 2023-03-21 | 어씨러스 메디컬, 엘엘씨 | Hybrid device for surgical aortic repair |
EP3270826B1 (en) | 2015-03-20 | 2020-01-01 | St. Jude Medical, Cardiology Division, Inc. | Mitral valve loading tool |
WO2016205826A1 (en) | 2015-06-18 | 2016-12-22 | Aortic Innovations, Llc | Branched aortic graft and method of using the same |
AU2015215913B1 (en) | 2015-08-20 | 2016-02-25 | Cook Medical Technologies Llc | An endograft delivery device assembly |
JP6854282B2 (en) * | 2015-09-18 | 2021-04-07 | テルモ株式会社 | Pressable implant delivery system |
EP3167845A1 (en) * | 2015-11-12 | 2017-05-17 | The Provost, Fellows, Foundation Scholars, & the other members of Board, of the College of Holy and Undiv. Trinity of Queen Elizabeth near Dublin | An implantable biocompatible expander suitable for treatment of constrictions of body lumen |
CN105943212B (en) * | 2015-12-23 | 2018-08-14 | 微创心脉医疗科技(上海)有限公司 | Stent delivery system and its Handleset |
JP2019509833A (en) * | 2016-03-29 | 2019-04-11 | ヴェニティ インコーポレイテッドVeniti, Inc. | Mechanical stent assisted delivery system |
EP3439583B1 (en) | 2016-04-05 | 2020-09-09 | Bolton Medical, Inc. | Stent graft with internal tunnels and fenestrations |
WO2017176678A1 (en) * | 2016-04-05 | 2017-10-12 | Bolton Medical, Inc. | Delivery device with filler tubes |
EP3454788B1 (en) | 2016-05-13 | 2020-02-05 | St. Jude Medical, Cardiology Division, Inc. | Mitral valve delivery device |
US10583005B2 (en) * | 2016-05-13 | 2020-03-10 | Boston Scientific Scimed, Inc. | Medical device handle |
WO2017205486A1 (en) | 2016-05-25 | 2017-11-30 | Bolton Medical, Inc. | Stent grafts and methods of use for treating aneurysms |
WO2017218474A1 (en) | 2016-06-13 | 2017-12-21 | Aortica Corporation | Systems, devices, and methods for marking and/or reinforcing fenestrations in prosthetic implants |
US10448938B2 (en) | 2016-06-16 | 2019-10-22 | Phillips Medical, LLC | Methods and systems for sealing a puncture of a vessel |
US10639147B2 (en) * | 2016-06-24 | 2020-05-05 | Edwards Lifesciences Corporation | System and method for crimping a prosthetic valve |
EP3493766B1 (en) | 2016-08-02 | 2024-03-06 | Bolton Medical, Inc. | Assembly for coupling a prosthetic implant to a fenestrated body |
CN106236343B (en) * | 2016-08-20 | 2018-02-16 | 科睿驰(深圳)医疗科技发展有限公司 | Memory push elongate catheter |
CN107157621A (en) * | 2016-09-23 | 2017-09-15 | 杭州启明医疗器械有限公司 | A kind of recyclable and resetting intervention apparatus induction system |
JP7183153B2 (en) * | 2016-10-04 | 2022-12-05 | マイクロベンション インコーポレイテッド | Methods and apparatus for stent delivery |
RU2652732C1 (en) * | 2016-12-30 | 2018-04-28 | Общество с ограниченной ответственностью "СЕВЕН САНС" | Device and method for safe positioning of coronary stent in coronary arteries |
RU2650038C1 (en) * | 2016-12-30 | 2018-04-06 | Общество с ограниченной ответственностью "СЕВЕН САНС" | Device and method for safe positioning of coronary stent in coronary arteries |
US10463517B2 (en) | 2017-01-16 | 2019-11-05 | Cook Medical Technologies Llc | Controlled expansion stent graft delivery system |
WO2018156851A1 (en) | 2017-02-24 | 2018-08-30 | Bolton Medical, Inc. | Vascular prosthesis with moveable fenestration |
EP3534848B1 (en) | 2017-02-24 | 2023-06-28 | Bolton Medical, Inc. | Stent graft delivery system with constricted sheath |
WO2018156849A1 (en) | 2017-02-24 | 2018-08-30 | Bolton Medical, Inc. | Vascular prosthesis with fenestration ring and methods of use |
WO2018156848A1 (en) | 2017-02-24 | 2018-08-30 | Bolton Medical, Inc. | Vascular prosthesis with crimped adapter and methods of use |
WO2018156847A1 (en) | 2017-02-24 | 2018-08-30 | Bolton Medical, Inc. | Delivery system and method to radially constrict a stent graft |
WO2018156850A1 (en) | 2017-02-24 | 2018-08-30 | Bolton Medical, Inc. | Stent graft with fenestration lock |
WO2018156854A1 (en) | 2017-02-24 | 2018-08-30 | Bolton Medical, Inc. | Radially adjustable stent graft delivery system |
CN110022795B (en) | 2017-02-24 | 2023-03-14 | 波顿医疗公司 | Constrained stent grafts, delivery systems and methods of use |
WO2018175048A1 (en) | 2017-03-24 | 2018-09-27 | Ascyrus Medical, Llc | Multi-spiral self-expanding stent and methods of making and using the same |
US10716551B2 (en) | 2017-05-12 | 2020-07-21 | Phillips Medical, LLC | Systems and methods for sealing a puncture of a vessel |
US10524820B2 (en) * | 2017-05-16 | 2020-01-07 | Biosense Webster (Israel) Ltd. | Deflectable shaver tool |
US10856982B2 (en) * | 2017-09-19 | 2020-12-08 | St. Jude Medical, Cardiology Division, Inc. | Transapical mitral valve delivery system |
JP7271510B2 (en) | 2017-09-25 | 2023-05-11 | ボルトン メディカル インコーポレイテッド | Systems, devices and methods for coupling prosthetic implants to fenestrated bodies |
EP3494936A1 (en) | 2017-12-05 | 2019-06-12 | Cook Medical Technologies LLC | Endograft delivery device assembly |
EP3737343B1 (en) | 2018-01-10 | 2021-12-29 | Boston Scientific Scimed Inc. | Stent delivery system with displaceable deployment mechanism |
CN110025415A (en) * | 2018-01-12 | 2019-07-19 | 上海微创心脉医疗科技股份有限公司 | A kind of handle of medical implant release system |
CN110786975B (en) * | 2018-08-03 | 2022-07-05 | 先健科技(深圳)有限公司 | Handle assembly of conveyor, conveyor and conveying system |
CN111067682B (en) * | 2018-10-22 | 2022-06-07 | 东莞市先健医疗有限公司 | Assembly and system for controlling release of implantable device |
CN111214310A (en) * | 2018-11-23 | 2020-06-02 | 上海微创心通医疗科技有限公司 | Drive handle for delivering an implant and delivery system |
CN111772873A (en) * | 2019-04-04 | 2020-10-16 | 上海微创心通医疗科技有限公司 | Drive handle for delivering an implant and delivery system |
US11166833B2 (en) | 2019-04-30 | 2021-11-09 | Cook Medical Technologies Llc | Line pull assembly for a prosthetic delivery device |
US11672661B2 (en) | 2019-08-22 | 2023-06-13 | Silara Medtech Inc. | Annuloplasty systems and methods |
CN110882096A (en) * | 2019-12-24 | 2020-03-17 | 上海蓝脉医疗科技有限公司 | Implant delivery system |
CN111388158B (en) * | 2020-01-20 | 2022-05-10 | 苏州恒瑞宏远医疗科技有限公司 | Conveying device |
US20210282952A1 (en) * | 2020-03-13 | 2021-09-16 | Medtronic Vascular, Inc. | Endovascular catheter with delivery system separately assembled to stent graft system |
CN112013762A (en) * | 2020-07-07 | 2020-12-01 | 辽宁省交通高等专科学校 | Large object photography positioning scanning modeling system |
WO2022173790A1 (en) * | 2021-02-10 | 2022-08-18 | Silara Medtech Inc. | Driving handle, apparatus and method for recapturing an implant |
CN113017947B (en) * | 2021-03-19 | 2022-09-30 | 埃文斯科技(北京)有限公司 | Self-expanding stent system capable of being released in segmented mode |
Citations (6)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4655771A (en) * | 1982-04-30 | 1987-04-07 | Shepherd Patents S.A. | Prosthesis comprising an expansible or contractile tubular body |
US6039749A (en) * | 1994-02-10 | 2000-03-21 | Endovascular Systems, Inc. | Method and apparatus for deploying non-circular stents and graftstent complexes |
US20030191516A1 (en) * | 2002-04-04 | 2003-10-09 | James Weldon | Delivery system and method for deployment of foreshortening endoluminal devices |
US20040059407A1 (en) * | 2002-09-23 | 2004-03-25 | Angeli Escamilla | Expandable stent and delivery system |
US20070233222A1 (en) * | 2006-02-21 | 2007-10-04 | Med Institute, Inc. | Split sheath deployment system |
US8858613B2 (en) * | 2010-09-20 | 2014-10-14 | Altura Medical, Inc. | Stent graft delivery systems and associated methods |
Family Cites Families (419)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US1012524A (en) | 1904-07-25 | 1911-12-19 | Francis B Crocker | Apparatus for automatic regulation of rectifiers and rotary converters. |
US1026407A (en) | 1908-12-21 | 1912-05-14 | Steel Shoe Company | Footwear. |
US1021345A (en) | 1911-01-07 | 1912-03-26 | Henry Welch | Xylophone. |
FR1020621A (en) * | 1950-06-21 | 1953-02-09 | Mechanical chuck | |
US5190546A (en) | 1983-10-14 | 1993-03-02 | Raychem Corporation | Medical devices incorporating SIM alloy elements |
US5104399A (en) | 1986-12-10 | 1992-04-14 | Endovascular Technologies, Inc. | Artificial graft and implantation method |
US5693083A (en) * | 1983-12-09 | 1997-12-02 | Endovascular Technologies, Inc. | Thoracic graft and delivery catheter |
US6221102B1 (en) | 1983-12-09 | 2001-04-24 | Endovascular Technologies, Inc. | Intraluminal grafting system |
US4562596A (en) | 1984-04-25 | 1986-01-07 | Elliot Kornberg | Aortic graft, device and method for performing an intraluminal abdominal aortic aneurysm repair |
SE8803444D0 (en) | 1988-09-28 | 1988-09-28 | Medinvent Sa | A DEVICE FOR TRANSLUMINAL IMPLANTATION OR EXTRACTION |
US5078726A (en) | 1989-02-01 | 1992-01-07 | Kreamer Jeffry W | Graft stent and method of repairing blood vessels |
US5578071A (en) | 1990-06-11 | 1996-11-26 | Parodi; Juan C. | Aortic graft |
US5360443A (en) | 1990-06-11 | 1994-11-01 | Barone Hector D | Aortic graft for repairing an abdominal aortic aneurysm |
US5160341A (en) | 1990-11-08 | 1992-11-03 | Advanced Surgical Intervention, Inc. | Resorbable urethral stent and apparatus for its insertion |
US5628783A (en) | 1991-04-11 | 1997-05-13 | Endovascular Technologies, Inc. | Bifurcated multicapsule intraluminal grafting system and method |
US6682557B1 (en) | 1991-04-11 | 2004-01-27 | Endovascular Technologies, Inc. | Bifurcated multicapsule intraluminal grafting system and method |
US5591172A (en) | 1991-06-14 | 1997-01-07 | Ams Medinvent S.A. | Transluminal implantation device |
EP0536610B1 (en) | 1991-10-11 | 1997-09-03 | Angiomed GmbH & Co. Medizintechnik KG | Stenosis dilatation device |
US5693084A (en) | 1991-10-25 | 1997-12-02 | Cook Incorporated | Expandable transluminal graft prosthesis for repair of aneurysm |
US5316023A (en) | 1992-01-08 | 1994-05-31 | Expandable Grafts Partnership | Method for bilateral intra-aortic bypass |
US5201757A (en) | 1992-04-03 | 1993-04-13 | Schneider (Usa) Inc. | Medial region deployment of radially self-expanding stents |
US5817102A (en) * | 1992-05-08 | 1998-10-06 | Schneider (Usa) Inc. | Apparatus for delivering and deploying a stent |
US5707376A (en) | 1992-08-06 | 1998-01-13 | William Cook Europe A/S | Stent introducer and method of use |
US5562725A (en) | 1992-09-14 | 1996-10-08 | Meadox Medicals Inc. | Radially self-expanding implantable intraluminal device |
US5364352A (en) | 1993-03-12 | 1994-11-15 | Heart Rhythm Technologies, Inc. | Catheter for electrophysiological procedures |
WO1994023786A1 (en) | 1993-04-13 | 1994-10-27 | Boston Scientific Corporation | Prosthesis delivery system |
US5480423A (en) | 1993-05-20 | 1996-01-02 | Boston Scientific Corporation | Prosthesis delivery |
US5464449A (en) | 1993-07-08 | 1995-11-07 | Thomas J. Fogarty | Internal graft prosthesis and delivery system |
US5639278A (en) | 1993-10-21 | 1997-06-17 | Corvita Corporation | Expandable supportive bifurcated endoluminal grafts |
US5723004A (en) | 1993-10-21 | 1998-03-03 | Corvita Corporation | Expandable supportive endoluminal grafts |
US5632772A (en) | 1993-10-21 | 1997-05-27 | Corvita Corporation | Expandable supportive branched endoluminal grafts |
US5855598A (en) | 1993-10-21 | 1999-01-05 | Corvita Corporation | Expandable supportive branched endoluminal grafts |
US5445646A (en) | 1993-10-22 | 1995-08-29 | Scimed Lifesystems, Inc. | Single layer hydraulic sheath stent delivery apparatus and method |
US5989280A (en) | 1993-10-22 | 1999-11-23 | Scimed Lifesystems, Inc | Stent delivery apparatus and method |
AU1091095A (en) | 1993-11-08 | 1995-05-29 | Harrison M. Lazarus | Intraluminal vascular graft and method |
US5476505A (en) | 1993-11-18 | 1995-12-19 | Advanced Cardiovascular Systems, Inc. | Coiled stent and delivery system |
US5527353A (en) | 1993-12-02 | 1996-06-18 | Meadox Medicals, Inc. | Implantable tubular prosthesis |
DE9319267U1 (en) | 1993-12-15 | 1994-02-24 | Vorwerk Dierk Dr | Aortic endoprosthesis |
US5476506A (en) | 1994-02-08 | 1995-12-19 | Ethicon, Inc. | Bi-directional crimped graft |
US5609627A (en) | 1994-02-09 | 1997-03-11 | Boston Scientific Technology, Inc. | Method for delivering a bifurcated endoluminal prosthesis |
US6165213A (en) | 1994-02-09 | 2000-12-26 | Boston Scientific Technology, Inc. | System and method for assembling an endoluminal prosthesis |
US6051020A (en) | 1994-02-09 | 2000-04-18 | Boston Scientific Technology, Inc. | Bifurcated endoluminal prosthesis |
US5507769A (en) | 1994-10-18 | 1996-04-16 | Stentco, Inc. | Method and apparatus for forming an endoluminal bifurcated graft |
US5415664A (en) | 1994-03-30 | 1995-05-16 | Corvita Corporation | Method and apparatus for introducing a stent or a stent-graft |
US5507731A (en) | 1994-05-17 | 1996-04-16 | Cordis Corporation | Rapid exchange segmented catheter |
US5824041A (en) | 1994-06-08 | 1998-10-20 | Medtronic, Inc. | Apparatus and methods for placement and repositioning of intraluminal prostheses |
US5683451A (en) | 1994-06-08 | 1997-11-04 | Cardiovascular Concepts, Inc. | Apparatus and methods for deployment release of intraluminal prostheses |
CA2147547C (en) | 1994-08-02 | 2006-12-19 | Peter J. Schmitt | Thinly woven flexible graft |
US5653743A (en) | 1994-09-09 | 1997-08-05 | Martin; Eric C. | Hypogastric artery bifurcation graft and method of implantation |
NL9500094A (en) | 1995-01-19 | 1996-09-02 | Industrial Res Bv | Y-shaped stent and method of deployment. |
US5755770A (en) | 1995-01-31 | 1998-05-26 | Boston Scientific Corporatiion | Endovascular aortic graft |
US5575818A (en) | 1995-02-14 | 1996-11-19 | Corvita Corporation | Endovascular stent with locking ring |
US5683449A (en) | 1995-02-24 | 1997-11-04 | Marcade; Jean Paul | Modular bifurcated intraluminal grafts and methods for delivering and assembling same |
EP0814729B1 (en) | 1995-03-10 | 2000-08-09 | Impra, Inc. | Endoluminal encapsulated stent and methods of manufacture |
AUPN228395A0 (en) | 1995-04-11 | 1995-05-04 | Hart, Vincent G. | Artificial arterial-venous graft |
US5591228A (en) | 1995-05-09 | 1997-01-07 | Edoga; John K. | Methods for treating abdominal aortic aneurysms |
US5681347A (en) | 1995-05-23 | 1997-10-28 | Boston Scientific Corporation | Vena cava filter delivery system |
EP0773754B1 (en) | 1995-05-25 | 2004-09-01 | Medtronic, Inc. | Stent assembly |
US5702418A (en) | 1995-09-12 | 1997-12-30 | Boston Scientific Corporation | Stent delivery system |
US6099558A (en) | 1995-10-10 | 2000-08-08 | Edwards Lifesciences Corp. | Intraluminal grafting of a bifuricated artery |
US5591195A (en) | 1995-10-30 | 1997-01-07 | Taheri; Syde | Apparatus and method for engrafting a blood vessel |
GB9522332D0 (en) | 1995-11-01 | 1996-01-03 | Biocompatibles Ltd | Braided stent |
US5628788A (en) | 1995-11-07 | 1997-05-13 | Corvita Corporation | Self-expanding endoluminal stent-graft |
US20080221668A1 (en) | 1995-11-13 | 2008-09-11 | Boston Scientific Corp. | Expandable supportive branched endoluminal grafts |
US6576009B2 (en) | 1995-12-01 | 2003-06-10 | Medtronic Ave, Inc. | Bifurcated intraluminal prostheses construction and methods |
US5626604A (en) | 1995-12-05 | 1997-05-06 | Cordis Corporation | Hand held stent crimping device |
FR2743293B1 (en) | 1996-01-08 | 1998-03-27 | Denis Jean Marc | AORTO-ILIAC STENT |
US5800512A (en) | 1996-01-22 | 1998-09-01 | Meadox Medicals, Inc. | PTFE vascular graft |
JPH09215753A (en) | 1996-02-08 | 1997-08-19 | Schneider Usa Inc | Self-expanding stent made of titanium alloy |
US5843160A (en) | 1996-04-01 | 1998-12-01 | Rhodes; Valentine J. | Prostheses for aneurysmal and/or occlusive disease at a bifurcation in a vessel, duct, or lumen |
US6629981B2 (en) | 2000-07-06 | 2003-10-07 | Endocare, Inc. | Stent delivery system |
US6413269B1 (en) | 2000-07-06 | 2002-07-02 | Endocare, Inc. | Stent delivery system |
BE1010183A3 (en) | 1996-04-25 | 1998-02-03 | Dereume Jean Pierre Georges Em | Luminal endoprosthesis FOR BRANCHING CHANNELS OF A HUMAN OR ANIMAL BODY AND MANUFACTURING METHOD THEREOF. |
US6592617B2 (en) | 1996-04-30 | 2003-07-15 | Boston Scientific Scimed, Inc. | Three-dimensional braided covered stent |
US6440165B1 (en) | 1996-05-03 | 2002-08-27 | Medinol, Ltd. | Bifurcated stent with improved side branch aperture and method of making same |
UA58485C2 (en) | 1996-05-03 | 2003-08-15 | Медінол Лтд. | Method for manufacture of bifurcated stent (variants) and bifurcated stent (variants) |
NL1003178C2 (en) | 1996-05-21 | 1997-11-25 | Cordis Europ | Tubular prosthesis made of curable material. |
US7238197B2 (en) * | 2000-05-30 | 2007-07-03 | Devax, Inc. | Endoprosthesis deployment system for treating vascular bifurcations |
CA2258732C (en) | 1996-06-20 | 2006-04-04 | Sulzer Vascutek Ltd. | Prosthetic repair of body passages |
US5928279A (en) | 1996-07-03 | 1999-07-27 | Baxter International Inc. | Stented, radially expandable, tubular PTFE grafts |
US6077295A (en) | 1996-07-15 | 2000-06-20 | Advanced Cardiovascular Systems, Inc. | Self-expanding stent delivery system |
US5830217A (en) | 1996-08-09 | 1998-11-03 | Thomas J. Fogarty | Soluble fixation device and method for stent delivery catheters |
US6325819B1 (en) | 1996-08-19 | 2001-12-04 | Cook Incorporated | Endovascular prosthetic device, an endovascular graft prothesis with such a device, and a method for repairing an abdominal aortic aneurysm |
US5968068A (en) | 1996-09-12 | 1999-10-19 | Baxter International Inc. | Endovascular delivery system |
US5968052A (en) | 1996-11-27 | 1999-10-19 | Scimed Life Systems Inc. | Pull back stent delivery system with pistol grip retraction handle |
US5897587A (en) | 1996-12-03 | 1999-04-27 | Atrium Medical Corporation | Multi-stage prosthesis |
US5776142A (en) * | 1996-12-19 | 1998-07-07 | Medtronic, Inc. | Controllable stent delivery system and method |
US6015431A (en) | 1996-12-23 | 2000-01-18 | Prograft Medical, Inc. | Endolumenal stent-graft with leak-resistant seal |
US5957974A (en) | 1997-01-23 | 1999-09-28 | Schneider (Usa) Inc | Stent graft with braided polymeric sleeve |
US6090128A (en) | 1997-02-20 | 2000-07-18 | Endologix, Inc. | Bifurcated vascular graft deployment device |
US6951572B1 (en) | 1997-02-20 | 2005-10-04 | Endologix, Inc. | Bifurcated vascular graft and method and apparatus for deploying same |
US5948483A (en) | 1997-03-25 | 1999-09-07 | The Board Of Trustees Of The University Of Illinois | Method and apparatus for producing thin film and nanoparticle deposits |
GR970100134A (en) | 1997-04-10 | 1998-12-31 | Bifurcated inravascular implant for the intravascular treatment of aneurysms of the abdominal aorta and implanting technique | |
GB9710366D0 (en) | 1997-05-20 | 1997-07-16 | Biocompatibles Ltd | Stent deployment device |
AUPO700897A0 (en) | 1997-05-26 | 1997-06-19 | William A Cook Australia Pty Ltd | A method and means of deploying a graft |
US6168616B1 (en) | 1997-06-02 | 2001-01-02 | Global Vascular Concepts | Manually expandable stent |
US6007575A (en) | 1997-06-06 | 1999-12-28 | Samuels; Shaun Laurence Wilkie | Inflatable intraluminal stent and method for affixing same within the human body |
US5904713A (en) | 1997-07-14 | 1999-05-18 | Datascope Investment Corp. | Invertible bifurcated stent/graft and method of deployment |
US5906619A (en) | 1997-07-24 | 1999-05-25 | Medtronic, Inc. | Disposable delivery device for endoluminal prostheses |
US6174330B1 (en) | 1997-08-01 | 2001-01-16 | Schneider (Usa) Inc | Bioabsorbable marker having radiopaque constituents |
US6070589A (en) | 1997-08-01 | 2000-06-06 | Teramed, Inc. | Methods for deploying bypass graft stents |
US6306164B1 (en) | 1997-09-05 | 2001-10-23 | C. R. Bard, Inc. | Short body endoprosthesis |
US5984955A (en) | 1997-09-11 | 1999-11-16 | Wisselink; Willem | System and method for endoluminal grafting of bifurcated or branched vessels |
US6179809B1 (en) | 1997-09-24 | 2001-01-30 | Eclipse Surgical Technologies, Inc. | Drug delivery catheter with tip alignment |
US6554794B1 (en) | 1997-09-24 | 2003-04-29 | Richard L. Mueller | Non-deforming deflectable multi-lumen catheter |
US6183444B1 (en) | 1998-05-16 | 2001-02-06 | Microheart, Inc. | Drug delivery module |
US6053899A (en) | 1997-10-02 | 2000-04-25 | Scimed Life Systems, Inc. | Material delivery device and method of using the same |
US6331191B1 (en) | 1997-11-25 | 2001-12-18 | Trivascular Inc. | Layered endovascular graft |
US6171277B1 (en) | 1997-12-01 | 2001-01-09 | Cordis Webster, Inc. | Bi-directional control handle for steerable catheter |
US6395019B2 (en) | 1998-02-09 | 2002-05-28 | Trivascular, Inc. | Endovascular graft |
FR2775182B1 (en) | 1998-02-25 | 2000-07-28 | Legona Anstalt | DEVICE FORMING INTRACORPOREAL ENDOLUMINAL ANDOPROTHESIS, IN PARTICULAR AORTIC ABDOMINAL |
US6077296A (en) | 1998-03-04 | 2000-06-20 | Endologix, Inc. | Endoluminal vascular prosthesis |
US6019778A (en) | 1998-03-13 | 2000-02-01 | Cordis Corporation | Delivery apparatus for a self-expanding stent |
US6129756A (en) | 1998-03-16 | 2000-10-10 | Teramed, Inc. | Biluminal endovascular graft system |
US6224609B1 (en) | 1998-03-16 | 2001-05-01 | Teramed Inc. | Bifurcated prosthetic graft |
EP0943300A1 (en) | 1998-03-17 | 1999-09-22 | Medicorp S.A. | Reversible action endoprosthesis delivery device. |
US6656215B1 (en) | 2000-11-16 | 2003-12-02 | Cordis Corporation | Stent graft having an improved means for attaching a stent to a graft |
US6290731B1 (en) | 1998-03-30 | 2001-09-18 | Cordis Corporation | Aortic graft having a precursor gasket for repairing an abdominal aortic aneurysm |
US6887268B2 (en) | 1998-03-30 | 2005-05-03 | Cordis Corporation | Extension prosthesis for an arterial repair |
US6520983B1 (en) | 1998-03-31 | 2003-02-18 | Scimed Life Systems, Inc. | Stent delivery system |
WO1999049808A1 (en) * | 1998-03-31 | 1999-10-07 | Salviac Limited | A delivery catheter |
US6524336B1 (en) | 1998-04-09 | 2003-02-25 | Cook Incorporated | Endovascular graft |
US6217609B1 (en) | 1998-06-30 | 2001-04-17 | Schneider (Usa) Inc | Implantable endoprosthesis with patterned terminated ends and methods for making same |
US6120522A (en) | 1998-08-27 | 2000-09-19 | Scimed Life Systems, Inc. | Self-expanding stent delivery catheter |
US6203550B1 (en) | 1998-09-30 | 2001-03-20 | Medtronic, Inc. | Disposable delivery device for endoluminal prostheses |
JP2002525168A (en) | 1998-09-30 | 2002-08-13 | インプラ・インコーポレーテッド | Introduction mechanism of implantable stent |
US6273909B1 (en) | 1998-10-05 | 2001-08-14 | Teramed Inc. | Endovascular graft system |
US6214036B1 (en) | 1998-11-09 | 2001-04-10 | Cordis Corporation | Stent which is easily recaptured and repositioned within the body |
US6371963B1 (en) | 1998-11-17 | 2002-04-16 | Scimed Life Systems, Inc. | Device for controlled endoscopic penetration of injection needle |
US6187036B1 (en) | 1998-12-11 | 2001-02-13 | Endologix, Inc. | Endoluminal vascular prosthesis |
US6660030B2 (en) | 1998-12-11 | 2003-12-09 | Endologix, Inc. | Bifurcation graft deployment catheter |
US6197049B1 (en) | 1999-02-17 | 2001-03-06 | Endologix, Inc. | Articulating bifurcation graft |
US6517571B1 (en) | 1999-01-22 | 2003-02-11 | Gore Enterprise Holdings, Inc. | Vascular graft with improved flow surfaces |
EP1600124B1 (en) | 1999-01-22 | 2008-01-02 | Gore Enterprise Holdings, Inc. | Method for compacting an endoprosthesis |
US7018401B1 (en) | 1999-02-01 | 2006-03-28 | Board Of Regents, The University Of Texas System | Woven intravascular devices and methods for making the same and apparatus for delivery of the same |
ES2313882T3 (en) | 1999-02-01 | 2009-03-16 | Board Of Regents, The University Of Texas System | ENDOVASCULAR PROTESTS FORKED AND FORKED FABRICS AND PROCEDURE FOR MANUFACTURING THE SAME. |
US6162246A (en) | 1999-02-16 | 2000-12-19 | Barone; Hector Daniel | Aortic graft and method of treating abdominal aortic aneurysms |
US6231597B1 (en) | 1999-02-16 | 2001-05-15 | Mark E. Deem | Apparatus and methods for selectively stenting a portion of a vessel wall |
US6200339B1 (en) | 1999-02-23 | 2001-03-13 | Datascope Investment Corp. | Endovascular split-tube bifurcated graft prosthesis and an implantation method for such a prosthesis |
CA2359507C (en) | 1999-02-26 | 2005-03-29 | Vascular Architects, Inc. | Catheter assembly with endoluminal prosthesis and method for placing |
US6261316B1 (en) | 1999-03-11 | 2001-07-17 | Endologix, Inc. | Single puncture bifurcation graft deployment system |
US6743247B1 (en) | 1999-04-01 | 2004-06-01 | Scion Cardio-Vascular, Inc. | Locking frame, filter and deployment system |
US6190360B1 (en) | 1999-04-09 | 2001-02-20 | Endotex Interventional System | Stent delivery handle |
US6162237A (en) | 1999-04-19 | 2000-12-19 | Chan; Winston Kam Yew | Temporary intravascular stent for use in retrohepatic IVC or hepatic vein injury |
US6926724B1 (en) | 1999-05-04 | 2005-08-09 | City Of Hope | Visceral anastomotic device and method of using same |
US6468260B1 (en) | 1999-05-07 | 2002-10-22 | Biosense Webster, Inc. | Single gear drive bidirectional control handle for steerable catheter |
US6146415A (en) | 1999-05-07 | 2000-11-14 | Advanced Cardiovascular Systems, Inc. | Stent delivery system |
US6585756B1 (en) | 1999-05-14 | 2003-07-01 | Ernst P. Strecker | Implantable lumen prosthesis |
US6398802B1 (en) | 1999-06-21 | 2002-06-04 | Scimed Life Systems, Inc. | Low profile delivery system for stent and graft deployment |
US6306424B1 (en) | 1999-06-30 | 2001-10-23 | Ethicon, Inc. | Foam composite for the repair or regeneration of tissue |
US6652570B2 (en) | 1999-07-02 | 2003-11-25 | Scimed Life Systems, Inc. | Composite vascular graft |
US6440161B1 (en) | 1999-07-07 | 2002-08-27 | Endologix, Inc. | Dual wire placement catheter |
WO2001005332A1 (en) | 1999-07-16 | 2001-01-25 | Sunnanväder, Lars | A device for therapeutic treatment of a blood vessel |
US6230476B1 (en) | 1999-09-02 | 2001-05-15 | Gary W. Clem, Inc. | Row crop gathering belt for combine heads |
US6183481B1 (en) | 1999-09-22 | 2001-02-06 | Endomed Inc. | Delivery system for self-expanding stents and grafts |
US6344056B1 (en) | 1999-12-29 | 2002-02-05 | Edwards Lifesciences Corp. | Vascular grafts for bridging a vessel side branch |
US6270525B1 (en) | 1999-09-23 | 2001-08-07 | Cordis Corporation | Precursor stent gasket for receiving bilateral grafts having controlled contralateral guidewire access |
US6344052B1 (en) | 1999-09-27 | 2002-02-05 | World Medical Manufacturing Corporation | Tubular graft with monofilament fibers |
US6849087B1 (en) | 1999-10-06 | 2005-02-01 | Timothy A. M. Chuter | Device and method for staged implantation of a graft for vascular repair |
US6383171B1 (en) | 1999-10-12 | 2002-05-07 | Allan Will | Methods and devices for protecting a passageway in a body when advancing devices through the passageway |
US6652567B1 (en) | 1999-11-18 | 2003-11-25 | David H. Deaton | Fenestrated endovascular graft |
US6280466B1 (en) | 1999-12-03 | 2001-08-28 | Teramed Inc. | Endovascular graft system |
GB0001102D0 (en) | 2000-01-19 | 2000-03-08 | Sulzer Vascutek Ltd | Prosthesis |
US6325822B1 (en) | 2000-01-31 | 2001-12-04 | Scimed Life Systems, Inc. | Braided stent having tapered filaments |
US6398807B1 (en) | 2000-01-31 | 2002-06-04 | Scimed Life Systems, Inc. | Braided branching stent, method for treating a lumen therewith, and process for manufacture therefor |
US6602280B2 (en) | 2000-02-02 | 2003-08-05 | Trivascular, Inc. | Delivery system and method for expandable intracorporeal device |
US6344044B1 (en) | 2000-02-11 | 2002-02-05 | Edwards Lifesciences Corp. | Apparatus and methods for delivery of intraluminal prosthesis |
US6808534B1 (en) | 2000-02-16 | 2004-10-26 | Endovascular Technologies, Inc. | Collapsible jacket guard |
US6814752B1 (en) | 2000-03-03 | 2004-11-09 | Endovascular Technologies, Inc. | Modular grafting system and method |
EP1263349B1 (en) | 2000-03-14 | 2009-08-05 | Cook Incorporated | Endovascular stent graft |
US6942691B1 (en) | 2000-04-27 | 2005-09-13 | Timothy A. M. Chuter | Modular bifurcated graft for endovascular aneurysm repair |
US6361556B1 (en) | 2000-04-27 | 2002-03-26 | Endovascular Tech Inc | System and method for endovascular aneurysm repair in conjuction with vascular stabilization |
US7226474B2 (en) | 2000-05-01 | 2007-06-05 | Endovascular Technologies, Inc. | Modular graft component junctions |
US7135037B1 (en) | 2000-05-01 | 2006-11-14 | Endovascular Technologies, Inc. | System and method for forming a junction between elements of a modular endovascular prosthesis |
US6572643B1 (en) | 2000-07-19 | 2003-06-03 | Vascular Architects, Inc. | Endoprosthesis delivery catheter assembly and method |
US6808533B1 (en) | 2000-07-28 | 2004-10-26 | Atrium Medical Corporation | Covered stent and method of covering a stent |
US6773454B2 (en) | 2000-08-02 | 2004-08-10 | Michael H. Wholey | Tapered endovascular stent graft and method of treating abdominal aortic aneurysms and distal iliac aneurysms |
US7118592B1 (en) | 2000-09-12 | 2006-10-10 | Advanced Cardiovascular Systems, Inc. | Covered stent assembly for reduced-shortening during stent expansion |
US6730119B1 (en) | 2000-10-06 | 2004-05-04 | Board Of Regents Of The University Of Texas System | Percutaneous implantation of partially covered stents in aneurysmally dilated arterial segments with subsequent embolization and obliteration of the aneurysm cavity |
US7314483B2 (en) | 2000-11-16 | 2008-01-01 | Cordis Corp. | Stent graft with branch leg |
US7267685B2 (en) | 2000-11-16 | 2007-09-11 | Cordis Corporation | Bilateral extension prosthesis and method of delivery |
US6942692B2 (en) | 2000-11-16 | 2005-09-13 | Cordis Corporation | Supra-renal prosthesis and renal artery bypass |
US7229472B2 (en) | 2000-11-16 | 2007-06-12 | Cordis Corporation | Thoracic aneurysm repair prosthesis and system |
US6843802B1 (en) | 2000-11-16 | 2005-01-18 | Cordis Corporation | Delivery apparatus for a self expanding retractable stent |
US6645242B1 (en) | 2000-12-11 | 2003-11-11 | Stephen F. Quinn | Bifurcated side-access intravascular stent graft |
US20020169497A1 (en) | 2001-01-02 | 2002-11-14 | Petra Wholey | Endovascular stent system and method of providing aneurysm embolization |
US6743210B2 (en) | 2001-02-15 | 2004-06-01 | Scimed Life Systems, Inc. | Stent delivery catheter positioning device |
US6602225B2 (en) | 2001-02-28 | 2003-08-05 | Scimed Life Systems, Inc | Substantially circular catheter assembly |
US8764817B2 (en) | 2001-03-05 | 2014-07-01 | Idev Technologies, Inc. | Methods for securing strands of woven medical devices and devices formed thereby |
ES2223759T3 (en) | 2001-03-27 | 2005-03-01 | William Cook Europe Aps | AORTIC GRAFT DEVICE. |
US20020143387A1 (en) | 2001-03-27 | 2002-10-03 | Soetikno Roy M. | Stent repositioning and removal |
DK1372534T3 (en) | 2001-03-28 | 2007-03-26 | Cook Inc | Set of sections for a modular stent implant device |
US20040138734A1 (en) | 2001-04-11 | 2004-07-15 | Trivascular, Inc. | Delivery system and method for bifurcated graft |
US7175651B2 (en) | 2001-07-06 | 2007-02-13 | Andrew Kerr | Stent/graft assembly |
US6761733B2 (en) | 2001-04-11 | 2004-07-13 | Trivascular, Inc. | Delivery system and method for bifurcated endovascular graft |
US20040073288A1 (en) | 2001-07-06 | 2004-04-15 | Andrew Kerr | Stent/graft assembly |
US6733521B2 (en) | 2001-04-11 | 2004-05-11 | Trivascular, Inc. | Delivery system and method for endovascular graft |
US20040215322A1 (en) | 2001-07-06 | 2004-10-28 | Andrew Kerr | Stent/graft assembly |
US20050021123A1 (en) | 2001-04-30 | 2005-01-27 | Jurgen Dorn | Variable speed self-expanding stent delivery system and luer locking connector |
US7828833B2 (en) | 2001-06-11 | 2010-11-09 | Boston Scientific Scimed, Inc. | Composite ePTFE/textile prosthesis |
EP1407388A4 (en) | 2001-06-27 | 2005-05-04 | Compumedics Ltd | Distributed event notification system |
US6716239B2 (en) | 2001-07-03 | 2004-04-06 | Scimed Life Systems, Inc. | ePTFE graft with axial elongation properties |
DE60230143D1 (en) | 2001-07-06 | 2009-01-15 | Angiomed Ag | DISTRIBUTION SYSTEM WITH A SLIDER ARRANGEMENT FOR A SELF-EXPANDING STENT AND A QUICK-CHANGE CONFIGURATION |
US20030014075A1 (en) | 2001-07-16 | 2003-01-16 | Microvention, Inc. | Methods, materials and apparatus for deterring or preventing endoleaks following endovascular graft implanation |
US6755854B2 (en) | 2001-07-31 | 2004-06-29 | Advanced Cardiovascular Systems, Inc. | Control device and mechanism for deploying a self-expanding medical device |
GB0123633D0 (en) | 2001-10-02 | 2001-11-21 | Angiomed Ag | Stent delivery system |
US6866669B2 (en) | 2001-10-12 | 2005-03-15 | Cordis Corporation | Locking handle deployment mechanism for medical device and method |
US6939352B2 (en) | 2001-10-12 | 2005-09-06 | Cordis Corporation | Handle deployment mechanism for medical device and method |
US20030074055A1 (en) | 2001-10-17 | 2003-04-17 | Haverkost Patrick A. | Method and system for fixation of endoluminal devices |
AUPR847301A0 (en) | 2001-10-26 | 2001-11-15 | Cook Incorporated | Endoluminal prostheses for curved lumens |
US6939376B2 (en) * | 2001-11-05 | 2005-09-06 | Sun Biomedical, Ltd. | Drug-delivery endovascular stent and method for treating restenosis |
US9320503B2 (en) | 2001-11-28 | 2016-04-26 | Medtronic Vascular, Inc. | Devices, system, and methods for guiding an operative tool into an interior body region |
US6929661B2 (en) | 2001-11-28 | 2005-08-16 | Aptus Endosystems, Inc. | Multi-lumen prosthesis systems and methods |
US7147657B2 (en) | 2003-10-23 | 2006-12-12 | Aptus Endosystems, Inc. | Prosthesis delivery systems and methods |
US7828838B2 (en) | 2001-11-28 | 2010-11-09 | Aptus Endosystems, Inc. | Devices, systems, and methods for prosthesis delivery and implantation, including a prosthesis assembly |
US20040186551A1 (en) * | 2003-01-17 | 2004-09-23 | Xtent, Inc. | Multiple independent nested stent structures and methods for their preparation and deployment |
US7147656B2 (en) | 2001-12-03 | 2006-12-12 | Xtent, Inc. | Apparatus and methods for delivery of braided prostheses |
US7014653B2 (en) | 2001-12-20 | 2006-03-21 | Cleveland Clinic Foundation | Furcated endovascular prosthesis |
US6913594B2 (en) | 2001-12-31 | 2005-07-05 | Biosense Webster, Inc. | Dual-function catheter handle |
US20030130725A1 (en) | 2002-01-08 | 2003-07-10 | Depalma Donald F. | Sealing prosthesis |
US20030130720A1 (en) | 2002-01-08 | 2003-07-10 | Depalma Donald F. | Modular aneurysm repair system |
US7326237B2 (en) | 2002-01-08 | 2008-02-05 | Cordis Corporation | Supra-renal anchoring prosthesis |
GB0203177D0 (en) | 2002-02-11 | 2002-03-27 | Anson Medical Ltd | An improved control mechanism for medical catheters |
US8211166B2 (en) | 2002-02-26 | 2012-07-03 | Endovascular Technologies, Inc. | Endovascular grafting device |
US7708771B2 (en) | 2002-02-26 | 2010-05-04 | Endovascular Technologies, Inc. | Endovascular graft device and methods for attaching components thereof |
US7063721B2 (en) | 2002-03-20 | 2006-06-20 | Terumo Kabushiki Kaisha | Woven tubing for stent type blood vascular prosthesis and stent type blood vascular prosthesis using the tubing |
US7000649B2 (en) | 2002-03-20 | 2006-02-21 | Terumo Kabushiki Kaisha | Woven tubing for stent type blood vascular prosthesis and stent type blood vascular prosthesis using the tubing |
WO2003082153A2 (en) | 2002-03-25 | 2003-10-09 | Cook Incorporated | Branched vessel prothesis |
US7105016B2 (en) | 2002-04-23 | 2006-09-12 | Medtronic Vascular, Inc. | Integrated mechanical handle with quick slide mechanism |
US6911039B2 (en) | 2002-04-23 | 2005-06-28 | Medtronic Vascular, Inc. | Integrated mechanical handle with quick slide mechanism |
US7131991B2 (en) | 2002-04-24 | 2006-11-07 | Medtronic Vascular, Inc. | Endoluminal prosthetic assembly and extension method |
US6830575B2 (en) | 2002-05-08 | 2004-12-14 | Scimed Life Systems, Inc. | Method and device for providing full protection to a stent |
US20040117003A1 (en) | 2002-05-28 | 2004-06-17 | The Cleveland Clinic Foundation | Minimally invasive treatment system for aortic aneurysms |
US7264632B2 (en) | 2002-06-07 | 2007-09-04 | Medtronic Vascular, Inc. | Controlled deployment delivery system |
US6858038B2 (en) | 2002-06-21 | 2005-02-22 | Richard R. Heuser | Stent system |
DE60332733D1 (en) | 2002-06-28 | 2010-07-08 | Cook Inc | Thorax-aortenaneurysma-stentimplantat |
US7314484B2 (en) | 2002-07-02 | 2008-01-01 | The Foundry, Inc. | Methods and devices for treating aneurysms |
US11890181B2 (en) | 2002-07-22 | 2024-02-06 | Tmt Systems, Inc. | Percutaneous endovascular apparatus for repair of aneurysms and arterial blockages |
US20040019375A1 (en) | 2002-07-26 | 2004-01-29 | Scimed Life Systems, Inc. | Sectional crimped graft |
US6984243B2 (en) | 2002-07-30 | 2006-01-10 | Cordis Corporation | Abrasion resistant vascular graft |
US7550004B2 (en) | 2002-08-20 | 2009-06-23 | Cook Biotech Incorporated | Endoluminal device with extracellular matrix material and methods |
AU2003272226A1 (en) | 2002-08-20 | 2004-03-11 | Cook Incorporated | Stent graft with improved proximal end |
US7294147B2 (en) | 2002-08-23 | 2007-11-13 | Cook Incorporated | Composite prosthesis |
US7264631B2 (en) | 2002-09-16 | 2007-09-04 | Scimed Life Systems, Inc. | Devices and methods for AAA management |
US20040059406A1 (en) | 2002-09-20 | 2004-03-25 | Cully Edward H. | Medical device amenable to fenestration |
DE60325999D1 (en) | 2002-12-04 | 2009-03-12 | Cook Inc | DEVICE FOR TREATING THE THORAX AORTA |
BR0317876A (en) | 2002-12-31 | 2005-12-06 | Nicholas V Perricone | Stable Topical Drug Release Compositions |
US6849084B2 (en) * | 2002-12-31 | 2005-02-01 | Intek Technology L.L.C. | Stent delivery system |
US7763062B2 (en) | 2003-01-21 | 2010-07-27 | Boston Scientific Scimed, Inc. | Method and system for delivering and implanting a graft |
ITTO20030037A1 (en) | 2003-01-24 | 2004-07-25 | Sorin Biomedica Cardio S P A Ora S Orin Biomedica | CATHETER DRIVE DEVICE. |
US20040260382A1 (en) | 2003-02-12 | 2004-12-23 | Fogarty Thomas J. | Intravascular implants and methods of using the same |
US7169118B2 (en) | 2003-02-26 | 2007-01-30 | Scimed Life Systems, Inc. | Elongate medical device with distal cap |
US7220274B1 (en) | 2003-03-21 | 2007-05-22 | Quinn Stephen F | Intravascular stent grafts and methods for deploying the same |
WO2004093746A1 (en) | 2003-03-26 | 2004-11-04 | The Foundry Inc. | Devices and methods for treatment of abdominal aortic aneurysm |
US6984244B2 (en) | 2003-03-27 | 2006-01-10 | Endovascular Technologies, Inc. | Delivery system for endoluminal implant |
US7473271B2 (en) * | 2003-04-11 | 2009-01-06 | Boston Scientific Scimed, Inc. | Stent delivery system with securement and deployment accuracy |
US20070032852A1 (en) | 2003-04-25 | 2007-02-08 | Medtronic Vascular, Inc. | Methods and Apparatus for Treatment of Aneurysms Adjacent to Branch Arteries |
US20050033416A1 (en) | 2003-05-02 | 2005-02-10 | Jacques Seguin | Vascular graft and deployment system |
US20040230289A1 (en) | 2003-05-15 | 2004-11-18 | Scimed Life Systems, Inc. | Sealable attachment of endovascular stent to graft |
US7235093B2 (en) | 2003-05-20 | 2007-06-26 | Boston Scientific Scimed, Inc. | Mechanism to improve stent securement |
JP2006526464A (en) | 2003-06-05 | 2006-11-24 | フローメディカ,インコーポレイテッド | System and method for performing bilateral intervention or diagnosis in a branched body lumen |
US8721710B2 (en) | 2003-08-11 | 2014-05-13 | Hdh Medical Ltd. | Anastomosis system and method |
US7628806B2 (en) | 2003-08-20 | 2009-12-08 | Boston Scientific Scimed, Inc. | Stent with improved resistance to migration |
JP4713478B2 (en) | 2003-09-02 | 2011-06-29 | アボット・ラボラトリーズ | Medical device delivery system |
US7758625B2 (en) | 2003-09-12 | 2010-07-20 | Abbott Vascular Solutions Inc. | Delivery system for medical devices |
US7993384B2 (en) | 2003-09-12 | 2011-08-09 | Abbott Cardiovascular Systems Inc. | Delivery system for medical devices |
WO2005032340A2 (en) | 2003-09-29 | 2005-04-14 | Secant Medical, Llc | Integral support stent graft assembly |
US20050085894A1 (en) | 2003-10-16 | 2005-04-21 | Kershner James R. | High strength and lubricious materials for vascular grafts |
US7144421B2 (en) | 2003-11-06 | 2006-12-05 | Carpenter Judith T | Endovascular prosthesis, system and method |
US9095461B2 (en) | 2003-11-08 | 2015-08-04 | Cook Medical Technologies Llc | Aorta and branch vessel stent grafts and method |
EP1689329A2 (en) | 2003-11-12 | 2006-08-16 | Medtronic Vascular, Inc. | Cardiac valve annulus reduction system |
US7575591B2 (en) | 2003-12-01 | 2009-08-18 | Cordis Corporation | Prosthesis graft with Z pleating |
US20050137677A1 (en) | 2003-12-17 | 2005-06-23 | Rush Scott L. | Endovascular graft with differentiable porosity along its length |
US7326236B2 (en) * | 2003-12-23 | 2008-02-05 | Xtent, Inc. | Devices and methods for controlling and indicating the length of an interventional element |
US20050154441A1 (en) | 2004-01-14 | 2005-07-14 | Cook Incorporated | Introducer |
US20070173917A1 (en) | 2004-02-27 | 2007-07-26 | Fumihiro Hayashi | Composite structure and process for producing the same |
EP1753367A4 (en) | 2004-03-11 | 2011-10-12 | Trivascular Inc | Modular endovascular graft |
JP2007532250A (en) | 2004-04-12 | 2007-11-15 | クック・インコーポレイテッド | Stent graft repair device |
US7682381B2 (en) | 2004-04-23 | 2010-03-23 | Boston Scientific Scimed, Inc. | Composite medical textile material and implantable devices made therefrom |
US7766960B2 (en) | 2004-04-30 | 2010-08-03 | Novostent Corporation | Delivery catheter that controls foreshortening of ribbon-type prostheses and methods of making and use |
US20050246008A1 (en) * | 2004-04-30 | 2005-11-03 | Novostent Corporation | Delivery system for vascular prostheses and methods of use |
WO2005112823A1 (en) | 2004-05-04 | 2005-12-01 | The Board Of Regents Of The University Of Texas System | Percutaneous implantation of partially covered stents in aneurysmally dilated arterial segments with subsequent embolization and obliteration of the aneurysm cavity |
US8267985B2 (en) * | 2005-05-25 | 2012-09-18 | Tyco Healthcare Group Lp | System and method for delivering and deploying an occluding device within a vessel |
US20050273154A1 (en) | 2004-06-08 | 2005-12-08 | Colone William M | Bifurcated stent graft and apparatus for making same |
US7318835B2 (en) | 2004-07-20 | 2008-01-15 | Medtronic Vascular, Inc. | Endoluminal prosthesis having expandable graft sections |
US8048145B2 (en) | 2004-07-22 | 2011-11-01 | Endologix, Inc. | Graft systems having filling structures supported by scaffolds and methods for their use |
EP2422745B1 (en) | 2004-07-22 | 2014-04-02 | Endologix, Inc. | Systems for endovascular aneurysm treatment |
EP1621158A1 (en) | 2004-07-28 | 2006-02-01 | Cordis Corporation | Reduced profile abdominal aortic aneurysm device |
EP1773249B1 (en) | 2004-07-28 | 2009-12-09 | Cordis Corporation | Abdominal aortic aneurism (aaa) low profile support structure |
US20060030921A1 (en) | 2004-08-03 | 2006-02-09 | Medtronic Vascular, Inc. | Intravascular securement device |
US7695506B2 (en) | 2004-09-21 | 2010-04-13 | Boston Scientific Scimed, Inc. | Atraumatic connections for multi-component stents |
US20060069323A1 (en) | 2004-09-24 | 2006-03-30 | Flowmedica, Inc. | Systems and methods for bi-lateral guidewire cannulation of branched body lumens |
US20070179600A1 (en) | 2004-10-04 | 2007-08-02 | Gil Vardi | Stent graft including expandable cuff |
US20060074481A1 (en) | 2004-10-04 | 2006-04-06 | Gil Vardi | Graft including expandable cuff |
US7344560B2 (en) | 2004-10-08 | 2008-03-18 | Boston Scientific Scimed, Inc. | Medical devices and methods of making the same |
US20060085057A1 (en) | 2004-10-14 | 2006-04-20 | Cardiomind | Delivery guide member based stent anti-jumping technologies |
EP1807022A2 (en) | 2004-11-03 | 2007-07-18 | Jacques Seguin | Vascular graft and deployment system |
EP2407127B1 (en) | 2004-11-10 | 2014-04-23 | Boston Scientific Scimed, Inc. | Atraumatic stent with reduced deployment force |
US20080108969A1 (en) | 2005-11-28 | 2008-05-08 | Andrew Kerr | Dialysis Catheter |
US7691095B2 (en) | 2004-12-28 | 2010-04-06 | St. Jude Medical, Atrial Fibrillation Division, Inc. | Bi-directional steerable catheter control handle |
US7588596B2 (en) | 2004-12-29 | 2009-09-15 | Scimed Life Systems, Inc. | Endoluminal prosthesis adapted to resist migration and method of deploying the same |
US20060155366A1 (en) | 2005-01-10 | 2006-07-13 | Laduca Robert | Apparatus and method for deploying an implantable device within the body |
US8287583B2 (en) | 2005-01-10 | 2012-10-16 | Taheri Laduca Llc | Apparatus and method for deploying an implantable device within the body |
US7578838B2 (en) | 2005-01-12 | 2009-08-25 | Cook Incorporated | Delivery system with helical shaft |
US7306623B2 (en) | 2005-01-13 | 2007-12-11 | Medtronic Vascular, Inc. | Branch vessel graft design and deployment method |
AU2006206259A1 (en) | 2005-01-21 | 2006-07-27 | Gen 4, Llc | Modular stent graft employing bifurcated graft and leg locking stent elements |
US7918880B2 (en) | 2005-02-16 | 2011-04-05 | Boston Scientific Scimed, Inc. | Self-expanding stent and delivery system |
US20060224232A1 (en) | 2005-04-01 | 2006-10-05 | Trivascular, Inc. | Hybrid modular endovascular graft |
US20060233990A1 (en) | 2005-04-13 | 2006-10-19 | Trivascular, Inc. | PTFE layers and methods of manufacturing |
US20060233991A1 (en) | 2005-04-13 | 2006-10-19 | Trivascular, Inc. | PTFE layers and methods of manufacturing |
JP5070373B2 (en) | 2005-04-28 | 2012-11-14 | エンドーロジックス インコーポレイテッド | Graft system having a filling structure supported by a framework and method of use thereof |
US8357190B2 (en) | 2005-05-10 | 2013-01-22 | Cook Medical Technologies Llc | Laparoscopic vascular access |
US7935140B2 (en) | 2005-05-13 | 2011-05-03 | Merit Medical Systems, Inc. | Delivery device with anchoring features and associated method |
CN2817768Y (en) | 2005-05-24 | 2006-09-20 | 微创医疗器械(上海)有限公司 | Tectorium stand and host cage section thereof |
GB0512319D0 (en) | 2005-06-16 | 2005-07-27 | Angiomed Ag | Catheter device variable pusher |
CA2614203A1 (en) | 2005-07-07 | 2007-01-18 | Nellix, Inc. | Systems and methods for endovascular aneurysm treatment |
US9149378B2 (en) | 2005-08-02 | 2015-10-06 | Reva Medical, Inc. | Axially nested slide and lock expandable device |
CA2619587C (en) | 2005-08-18 | 2014-06-10 | William A. Cook Australia Pty. Ltd. | Assembly of stent grafts |
US20070055341A1 (en) | 2005-08-26 | 2007-03-08 | Vascular And Endovascular Surgical Technologies, Inc. | Endograft |
US8911491B2 (en) | 2005-09-02 | 2014-12-16 | Medtronic Vascular, Inc. | Methods and apparatus for treatment of aneurysms adjacent branch arteries including branch artery flow lumen alignment |
US8551153B2 (en) | 2005-12-20 | 2013-10-08 | Cordis Corporation | Prosthesis comprising a coiled stent and method of use thereof |
US20070150041A1 (en) | 2005-12-22 | 2007-06-28 | Nellix, Inc. | Methods and systems for aneurysm treatment using filling structures |
US8167892B2 (en) | 2005-12-29 | 2012-05-01 | Cordis Corporation | Adjustable and detached stent deployment device |
US20070156229A1 (en) | 2005-12-30 | 2007-07-05 | Park Jin S | "D"-shape stent for treatment of abdominal aortic aneurysm |
US20070156224A1 (en) | 2006-01-04 | 2007-07-05 | Iulian Cioanta | Handle system for deploying a prosthetic implant |
US20070162109A1 (en) | 2006-01-11 | 2007-07-12 | Luis Davila | Intraluminal stent graft |
US8900287B2 (en) | 2006-01-13 | 2014-12-02 | Aga Medical Corporation | Intravascular deliverable stent for reinforcement of abdominal aortic aneurysm |
US9375215B2 (en) | 2006-01-20 | 2016-06-28 | W. L. Gore & Associates, Inc. | Device for rapid repair of body conduits |
US8083792B2 (en) | 2006-01-24 | 2011-12-27 | Cordis Corporation | Percutaneous endoprosthesis using suprarenal fixation and barbed anchors |
US20080114435A1 (en) | 2006-03-07 | 2008-05-15 | Med Institute, Inc. | Flexible delivery system |
US8197536B2 (en) | 2006-03-10 | 2012-06-12 | Cordis Corporation | Method for placing a medical device at a bifurcated conduit |
US20070225797A1 (en) | 2006-03-24 | 2007-09-27 | Medtronic Vascular, Inc. | Prosthesis With Adjustable Opening for Side Branch Access |
US7481836B2 (en) | 2006-03-30 | 2009-01-27 | Medtronic Vascular, Inc. | Prosthesis with coupling zone and methods |
US9757260B2 (en) | 2006-03-30 | 2017-09-12 | Medtronic Vascular, Inc. | Prosthesis with guide lumen |
US20070244547A1 (en) | 2006-04-18 | 2007-10-18 | Medtronic Vascular, Inc., A Delaware Corporation | Device and Method for Controlling the Positioning of a Stent Graft Fenestration |
US7678141B2 (en) | 2006-04-18 | 2010-03-16 | Medtronic Vascular, Inc. | Stent graft having a flexible, articulable, and axially compressible branch graft |
EP2366362B1 (en) | 2006-04-27 | 2020-05-06 | Cook Medical Technologies LLC | Deploying medical implants |
US7615044B2 (en) | 2006-05-03 | 2009-11-10 | Greatbatch Ltd. | Deflectable sheath handle assembly and method therefor |
US20100292771A1 (en) | 2009-05-18 | 2010-11-18 | Syncardia Systems, Inc | Endovascular stent graft system and guide system |
CA2653190C (en) | 2006-06-06 | 2015-07-14 | Cook Incorporated | Stent with a crush-resistant zone |
KR20090025331A (en) | 2006-06-20 | 2009-03-10 | 가부시키가이샤 엔티티 도코모 | Radio communication device and method used in mobile communication system |
US20080077231A1 (en) | 2006-07-06 | 2008-03-27 | Prescient Medical, Inc. | Expandable vascular endoluminal prostheses |
US8202310B2 (en) | 2006-07-14 | 2012-06-19 | Cordis Corporation | AAA repair device with aneurysm sac access port |
AU2007284361B2 (en) | 2006-08-18 | 2012-06-14 | Cook Incorporated | Stent graft extension |
EP2066269B1 (en) | 2006-09-28 | 2012-02-08 | Cook Medical Technologies LLC | Thoracic aortic aneurysm repair apparatus |
KR101659197B1 (en) | 2006-10-22 | 2016-09-22 | 이데브 테크놀로지스, 아이엔씨. | Devices and methods for stent advancement |
CN102525700B (en) | 2006-10-22 | 2015-05-13 | Idev科技公司 | Support pushing device |
US20080114444A1 (en) | 2006-11-09 | 2008-05-15 | Chun Ho Yu | Modular stent graft and delivery system |
US8052732B2 (en) | 2006-11-14 | 2011-11-08 | Medtronic Vascular, Inc. | Delivery system for stent-graft with anchoring pins |
KR100801122B1 (en) | 2006-11-17 | 2008-02-05 | (주)블루버드 소프트 | Mobile terminal |
US7252042B1 (en) * | 2006-11-29 | 2007-08-07 | George Berend Freeman Blake | Fertilizer spike injection tool |
US9044311B2 (en) | 2006-11-30 | 2015-06-02 | Cook Medical Technologies Llc | Aortic graft device |
US8216298B2 (en) | 2007-01-05 | 2012-07-10 | Medtronic Vascular, Inc. | Branch vessel graft method and delivery system |
WO2008091409A1 (en) | 2007-01-25 | 2008-07-31 | Boston Scientific Limited | Endoscope with preloaded or preloadable stent |
WO2008094601A2 (en) | 2007-01-31 | 2008-08-07 | William A. Cook Australia Pty. Ltd. | Endoscopic delivery device |
JP5662683B2 (en) | 2007-02-09 | 2015-02-04 | タヘリ ラドュカ エルエルシー | Apparatus and method for deploying an implantable device in a body |
US20080208325A1 (en) | 2007-02-27 | 2008-08-28 | Boston Scientific Scimed, Inc. | Medical articles for long term implantation |
WO2008124728A1 (en) | 2007-04-09 | 2008-10-16 | Ev3 Peripheral, Inc. | Stretchable stent and delivery system |
WO2008124844A1 (en) * | 2007-04-10 | 2008-10-16 | Edwards Lifesciences Corporation | Catheter having retractable sheath |
US8715336B2 (en) | 2007-04-19 | 2014-05-06 | Medtronic Vascular, Inc. | Methods and apparatus for treatment of aneurysms adjacent to branch arteries |
US20110022149A1 (en) | 2007-06-04 | 2011-01-27 | Cox Brian J | Methods and devices for treatment of vascular defects |
US8048147B2 (en) | 2007-06-27 | 2011-11-01 | Aga Medical Corporation | Branched stent/graft and method of fabrication |
US8372131B2 (en) | 2007-07-16 | 2013-02-12 | Power Ten , LLC | Surgical site access system and deployment device for same |
US20090043376A1 (en) | 2007-08-08 | 2009-02-12 | Hamer Rochelle M | Endoluminal Prosthetic Conduit Systems and Method of Coupling |
US8390107B2 (en) | 2007-09-28 | 2013-03-05 | Intel Mobile Communications GmbH | Semiconductor device and methods of manufacturing semiconductor devices |
JP2010540190A (en) | 2007-10-04 | 2010-12-24 | トリバスキュラー・インコーポレイテッド | Modular vascular graft for low profile transdermal delivery |
US9414842B2 (en) | 2007-10-12 | 2016-08-16 | St. Jude Medical, Cardiology Division, Inc. | Multi-component vascular device |
US9107741B2 (en) | 2007-11-01 | 2015-08-18 | Cook Medical Technologies Llc | Flexible stent graft |
US20090164001A1 (en) | 2007-12-21 | 2009-06-25 | Biggs David P | Socket For Fenestrated Tubular Prosthesis |
US8021413B2 (en) | 2007-12-27 | 2011-09-20 | Cook Medical Technologies Llc | Low profile medical device |
US20090171451A1 (en) | 2007-12-27 | 2009-07-02 | Cook Incorporated | Implantable device having composite weave |
US8926688B2 (en) | 2008-01-11 | 2015-01-06 | W. L. Gore & Assoc. Inc. | Stent having adjacent elements connected by flexible webs |
EP2240215B1 (en) | 2008-01-17 | 2014-01-08 | Boston Scientific Scimed, Inc. | Stent with anti-migration feature |
WO2009103011A1 (en) | 2008-02-13 | 2009-08-20 | Nellix, Inc. | Graft endoframe having axially variable characteristics |
US8163004B2 (en) | 2008-02-18 | 2012-04-24 | Aga Medical Corporation | Stent graft for reinforcement of vascular abnormalities and associated method |
US20090228020A1 (en) | 2008-03-06 | 2009-09-10 | Hansen Medical, Inc. | In-situ graft fenestration |
US7655037B2 (en) | 2008-04-17 | 2010-02-02 | Cordis Corporation | Combination barb restraint and stent attachment deployment mechanism |
CA2721950A1 (en) | 2008-04-25 | 2009-10-29 | Nellix, Inc. | Stent graft delivery system |
US20100305686A1 (en) | 2008-05-15 | 2010-12-02 | Cragg Andrew H | Low-profile modular abdominal aortic aneurysm graft |
US20090287145A1 (en) | 2008-05-15 | 2009-11-19 | Altura Interventional, Inc. | Devices and methods for treatment of abdominal aortic aneurysms |
WO2009149294A1 (en) | 2008-06-04 | 2009-12-10 | Nellix, Inc. | Sealing apparatus and methods of use |
EP2299933A4 (en) | 2008-06-04 | 2015-07-29 | Endologix Inc | Docking apparatus and methods of use |
US8114147B2 (en) | 2008-06-16 | 2012-02-14 | Boston Scientific Scimed, Inc. | Continuous double layered stent for migration resistance |
CN102076281B (en) | 2008-06-30 | 2014-11-05 | 波顿医疗公司 | Abdominal aortic aneurysms: systems and methods of use |
US20100030321A1 (en) | 2008-07-29 | 2010-02-04 | Aga Medical Corporation | Medical device including corrugated braid and associated method |
DE102008048533A1 (en) | 2008-09-16 | 2010-03-25 | Jotec Gmbh | Delivery system for discontinuing catheter-based stent devices |
US9375307B2 (en) | 2008-09-17 | 2016-06-28 | Cook Medical Technologies Llc | Graft fabric crimping pattern |
US9149376B2 (en) | 2008-10-06 | 2015-10-06 | Cordis Corporation | Reconstrainable stent delivery system |
US9597214B2 (en) | 2008-10-10 | 2017-03-21 | Kevin Heraty | Medical device |
US8986361B2 (en) | 2008-10-17 | 2015-03-24 | Medtronic Corevalve, Inc. | Delivery system for deployment of medical devices |
US9339630B2 (en) * | 2009-02-19 | 2016-05-17 | Medtronic Vascular, Inc. | Retractable drug delivery system and method |
US9427302B2 (en) | 2009-04-09 | 2016-08-30 | Medtronic Vascular, Inc. | Stent having a C-shaped body section for use in a bifurcation |
EP2419061A1 (en) | 2009-04-16 | 2012-02-22 | Cook Medical Technologies LLC | Introducer assembly |
US8540764B2 (en) | 2009-04-17 | 2013-09-24 | Medtronic Vascular, Inc. | Mobile external coupling for branch vessel connection |
US8945202B2 (en) | 2009-04-28 | 2015-02-03 | Endologix, Inc. | Fenestrated prosthesis |
EP2448519A1 (en) | 2009-07-01 | 2012-05-09 | Correx, INC. | Method and apparatus for effecting an aortic valve bypass, including the provision and use of a t-stent for effecting a distal anastomosis for the same |
WO2011031587A1 (en) * | 2009-09-10 | 2011-03-17 | Boston Scientific Scimed, Inc. | Endoprosthesis with filament repositioning or retrieval member and guard structure |
WO2011049808A1 (en) | 2009-10-20 | 2011-04-28 | William A. Cook Australia Pty, Ltd. | Rotational controlled deployment device |
US20110130819A1 (en) | 2009-12-01 | 2011-06-02 | Altura Medical, Inc. | Modular endograft devices and associated systems and methods |
US20110213450A1 (en) | 2010-03-01 | 2011-09-01 | Koven Technology Canada, Inc. | Medical device delivery system |
WO2011115421A2 (en) * | 2010-03-17 | 2011-09-22 | Lg Electronics Inc. | Method and apparatus for providing channel state information-reference signal (csi-rs) configuration information in a wireless communication system supporting multiple antennas |
US8663305B2 (en) * | 2010-04-20 | 2014-03-04 | Medtronic Vascular, Inc. | Retraction mechanism and method for graft cover retraction |
US8764811B2 (en) | 2010-04-20 | 2014-07-01 | Medtronic Vascular, Inc. | Controlled tip release stent graft delivery system and method |
US9326870B2 (en) * | 2010-04-23 | 2016-05-03 | Medtronic Vascular, Inc. | Biodegradable stent having non-biodegradable end portions and mechanisms for increased stent hoop strength |
US8623064B2 (en) * | 2010-04-30 | 2014-01-07 | Medtronic Vascular, Inc. | Stent graft delivery system and method of use |
US9023095B2 (en) | 2010-05-27 | 2015-05-05 | Idev Technologies, Inc. | Stent delivery system with pusher assembly |
US9301864B2 (en) * | 2010-06-08 | 2016-04-05 | Veniti, Inc. | Bi-directional stent delivery system |
EP2582333B1 (en) | 2010-06-18 | 2016-04-06 | Cook Medical Technologies LLC | Bifurcated stent introducer system |
CN102347817B (en) * | 2010-08-02 | 2014-01-08 | 华为技术有限公司 | Method for notifying reference signal configuration information and device thereof |
WO2012020963A2 (en) * | 2010-08-13 | 2012-02-16 | Lg Electronics Inc. | Method and base station for transmitting downlink signal and method and equipment for receiving downlink signal |
EP2651345B1 (en) | 2010-12-16 | 2018-05-16 | Cook Medical Technologies LLC | Handle control system for a stent delivery system |
CN102525698A (en) | 2010-12-31 | 2012-07-04 | 微创医疗器械(上海)有限公司 | Interposed medical appliance delivery and release device |
WO2012099731A1 (en) | 2011-01-19 | 2012-07-26 | Cook Medical Technologies Llc | Rotary and linear handle mechanism for constrained stent delivery system |
US9486348B2 (en) | 2011-02-01 | 2016-11-08 | S. Jude Medical, Cardiology Division, Inc. | Vascular delivery system and method |
WO2012118638A1 (en) | 2011-02-28 | 2012-09-07 | Cook Medical Technologies Llc | Short throw centered handle for stent delivery system |
AU2011202175B1 (en) | 2011-05-11 | 2011-07-28 | Cook Medical Technologies Llc | Rotation operated delivery device |
AU2012209013B2 (en) | 2011-08-02 | 2013-11-14 | Cook Medical Technologies Llc | Delivery device having a variable diameter introducer sheath |
CN104053417B (en) | 2011-11-15 | 2016-12-28 | 波士顿科学国际有限公司 | There is the medical apparatus and instruments of one or more sheath transition piece |
EP2882381B1 (en) | 2012-08-10 | 2018-12-26 | Lombard Medical Limited | Stent delivery system |
-
2013
- 2013-08-09 EP EP13753011.9A patent/EP2882381B1/en active Active
- 2013-08-09 CN CN201380053101.9A patent/CN105050549B/en active Active
- 2013-08-09 WO PCT/US2013/054438 patent/WO2014026173A1/en active Application Filing
- 2013-08-09 US US13/963,912 patent/US20140052232A1/en not_active Abandoned
- 2013-08-09 CA CA2881535A patent/CA2881535A1/en not_active Abandoned
- 2013-08-09 JP JP2015526747A patent/JP6326648B2/en active Active
- 2013-08-09 AU AU2013299425A patent/AU2013299425A1/en not_active Abandoned
- 2013-08-09 US US13/964,013 patent/US10285833B2/en active Active
- 2013-08-09 US US13/964,015 patent/US20140046429A1/en not_active Abandoned
Patent Citations (7)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4655771A (en) * | 1982-04-30 | 1987-04-07 | Shepherd Patents S.A. | Prosthesis comprising an expansible or contractile tubular body |
US4655771B1 (en) * | 1982-04-30 | 1996-09-10 | Medinvent Ams Sa | Prosthesis comprising an expansible or contractile tubular body |
US6039749A (en) * | 1994-02-10 | 2000-03-21 | Endovascular Systems, Inc. | Method and apparatus for deploying non-circular stents and graftstent complexes |
US20030191516A1 (en) * | 2002-04-04 | 2003-10-09 | James Weldon | Delivery system and method for deployment of foreshortening endoluminal devices |
US20040059407A1 (en) * | 2002-09-23 | 2004-03-25 | Angeli Escamilla | Expandable stent and delivery system |
US20070233222A1 (en) * | 2006-02-21 | 2007-10-04 | Med Institute, Inc. | Split sheath deployment system |
US8858613B2 (en) * | 2010-09-20 | 2014-10-14 | Altura Medical, Inc. | Stent graft delivery systems and associated methods |
Cited By (20)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US20100305686A1 (en) * | 2008-05-15 | 2010-12-02 | Cragg Andrew H | Low-profile modular abdominal aortic aneurysm graft |
US20110130819A1 (en) * | 2009-12-01 | 2011-06-02 | Altura Medical, Inc. | Modular endograft devices and associated systems and methods |
US20110130824A1 (en) * | 2009-12-01 | 2011-06-02 | Altura Medical, Inc. | Modular endograft devices and associated systems and methods |
US9572652B2 (en) | 2009-12-01 | 2017-02-21 | Altura Medical, Inc. | Modular endograft devices and associated systems and methods |
US10285833B2 (en) | 2012-08-10 | 2019-05-14 | Lombard Medical Limited | Stent delivery systems and associated methods |
US9737426B2 (en) | 2013-03-15 | 2017-08-22 | Altura Medical, Inc. | Endograft device delivery systems and associated methods |
US20180221036A1 (en) * | 2014-01-10 | 2018-08-09 | Boston Scientific Scimed, Inc. | Retrieval devices and related methods of use |
US10918403B2 (en) * | 2014-01-10 | 2021-02-16 | Boston Scientific Scimed, Inc. | Retrieval devices and related methods of use |
US20170172773A1 (en) * | 2014-05-21 | 2017-06-22 | Suzhou Innomed Medical Device Co., Ltd. | Highly retractable intravascular stent conveying system |
US10292848B2 (en) * | 2014-05-21 | 2019-05-21 | Suzhou Innomed Medical Device Co., Ltd. | Highly retractable intravascular stent conveying system |
US10603198B2 (en) | 2016-09-09 | 2020-03-31 | Cook Medical Technologies Llc | Prosthesis deployment system and method |
US11730584B2 (en) | 2017-02-24 | 2023-08-22 | Bolton Medical, Inc. | System and method to radially constrict a stent graft |
US11744722B2 (en) | 2017-02-24 | 2023-09-05 | Bolton Medical, Inc. | Method of use for delivery system for radially constricting a stent graft |
US10751056B2 (en) | 2017-10-23 | 2020-08-25 | High Desert Radiology, P.C. | Methods and apparatus for percutaneous bypass graft |
CN110121319A (en) * | 2017-10-31 | 2019-08-13 | 波顿医疗公司 | Distal side torque components, delivery system and its application method |
US11058566B2 (en) | 2018-04-11 | 2021-07-13 | Medtronic Vascular, Inc. | Variable rate prosthesis delivery system providing prosthesis alterations |
WO2020212972A1 (en) * | 2019-04-14 | 2020-10-22 | Perflow Medical Ltd. | Adaptable device and method for bridging a neck of an aneurysm |
US11622858B2 (en) * | 2019-10-09 | 2023-04-11 | Medtronic CV Luxembourg S.a.r.l. | Valve delivery system including foreshortening compensator for improved positioning accuracy |
WO2023107926A1 (en) * | 2021-12-08 | 2023-06-15 | Silk Road Medical, Inc. | Delivery systems for endoluminal prostheses and methods of use |
CN116942252A (en) * | 2023-09-20 | 2023-10-27 | 杭州亿科医疗科技有限公司 | Bolt taking device and bolt taking system |
Also Published As
Publication number | Publication date |
---|---|
EP2882381B1 (en) | 2018-12-26 |
CN105050549B (en) | 2017-07-21 |
JP2015524712A (en) | 2015-08-27 |
CN105050549A (en) | 2015-11-11 |
AU2013299425A1 (en) | 2015-03-19 |
EP2882381A1 (en) | 2015-06-17 |
WO2014026173A9 (en) | 2014-03-20 |
US20140046428A1 (en) | 2014-02-13 |
US20140052232A1 (en) | 2014-02-20 |
JP6326648B2 (en) | 2018-05-23 |
CA2881535A1 (en) | 2014-02-13 |
US10285833B2 (en) | 2019-05-14 |
WO2014026173A1 (en) | 2014-02-13 |
EP2882381A4 (en) | 2016-04-13 |
Similar Documents
Publication | Publication Date | Title |
---|---|---|
US10285833B2 (en) | Stent delivery systems and associated methods | |
EP3648709B1 (en) | Steerable rail delivery system | |
US9220616B2 (en) | Stent-graft delivery system having a rotatable single shaft tip capture mechanism | |
US20200060817A1 (en) | Medical implant deployment tool | |
US8920485B2 (en) | Stent-graft delivery system having a rotatable single shaft tip capture mechanism | |
US9301864B2 (en) | Bi-directional stent delivery system | |
EP2958528B1 (en) | Stent-graft delivery system having a tip capture mechanism with elongated cables for gradual deployment and repositioning | |
EP2579822B1 (en) | Bi-directional stent delivery system | |
CN108992218B (en) | Stent intubation guide for bifurcated stents and methods of use | |
WO2016123540A1 (en) | Reconstrainable stent delivery system with a proximal stop and an annular lock distal to the proximal stop and method | |
US20230000624A1 (en) | Delivery system configurations |
Legal Events
Date | Code | Title | Description |
---|---|---|---|
AS | Assignment |
Owner name: ALTURA MEDICAL, INC., CALIFORNIA Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNORS:CRAGG, ANDREW H;LOGAN, JOHN;TSAI, GEROGE;AND OTHERS;SIGNING DATES FROM 20131028 TO 20131106;REEL/FRAME:031983/0860 |
|
AS | Assignment |
Owner name: SILICON VALLEY BANK, CALIFORNIA Free format text: SECURITY AGREEMENT;ASSIGNOR:ALTURA MEDICAL, INC.;REEL/FRAME:034704/0682 Effective date: 20141201 Owner name: SILICON VALLEY BANK, CALIFORNIA Free format text: SECURITY AGREEMENT;ASSIGNOR:ALTURA MEDICAL, INC.;REEL/FRAME:034781/0718 Effective date: 20141201 |
|
AS | Assignment |
Owner name: ALTURA MEDICAL, INC., CALIFORNIA Free format text: RELEASE BY SECURED PARTY;ASSIGNOR:SILICON VALLEY BANK;REEL/FRAME:036565/0660 Effective date: 20150730 |
|
AS | Assignment |
Owner name: ALTURA MEDICAL, INC., CALIFORNIA Free format text: RELEASE;ASSIGNOR:SILICON VALLEY BANK;REEL/FRAME:036865/0590 Effective date: 20151007 |
|
STCB | Information on status: application discontinuation |
Free format text: ABANDONED -- FAILURE TO RESPOND TO AN OFFICE ACTION |