WO2005044073A2 - Prosthesis delivery systems and methods - Google Patents

Prosthesis delivery systems and methods Download PDF

Info

Publication number
WO2005044073A2
WO2005044073A2 PCT/US2004/027587 US2004027587W WO2005044073A2 WO 2005044073 A2 WO2005044073 A2 WO 2005044073A2 US 2004027587 W US2004027587 W US 2004027587W WO 2005044073 A2 WO2005044073 A2 WO 2005044073A2
Authority
WO
WIPO (PCT)
Prior art keywords
prosthesis
carrier
catheter
distal end
release
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.)
Ceased
Application number
PCT/US2004/027587
Other languages
English (en)
French (fr)
Other versions
WO2005044073A3 (en
Inventor
Andrew L. Chiang
Lee Bolduc
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Aptus Endosystems Inc
Original Assignee
Aptus Endosystems Inc
Priority date (The priority date 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 date listed.)
Filing date
Publication date
Application filed by Aptus Endosystems Inc filed Critical Aptus Endosystems Inc
Priority to CN2004800312370A priority Critical patent/CN1870950B/zh
Priority to AT04782144T priority patent/ATE438362T1/de
Priority to DK04782144T priority patent/DK1682039T3/da
Priority to DE602004022446T priority patent/DE602004022446D1/de
Priority to AU2004287353A priority patent/AU2004287353A1/en
Priority to EP04782144A priority patent/EP1682039B1/en
Priority to JP2006536615A priority patent/JP4912883B2/ja
Priority to CA002539265A priority patent/CA2539265A1/en
Publication of WO2005044073A2 publication Critical patent/WO2005044073A2/en
Publication of WO2005044073A3 publication Critical patent/WO2005044073A3/en
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

Links

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
    • A61F2/02—Prostheses implantable into the body
    • A61F2/04—Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
    • A61F2/06—Blood vessels
    • A61F2/07—Stent-grafts
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/95—Instruments specially adapted for placement or removal of stents or stent-grafts
    • A61F2/954—Instruments specially adapted for placement or removal of stents or stent-grafts for placing stents or stent-grafts in a bifurcation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/95—Instruments specially adapted for placement or removal of stents or stent-grafts
    • A61F2/962—Instruments specially adapted for placement or removal of stents or stent-grafts having an outer sleeve
    • A61F2/966—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
    • A61F2/9661—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 the proximal portion of the stent or stent-graft is released first
    • 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
    • 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
    • A61F2002/9505—Instruments specially adapted for placement or removal of stents or stent-grafts having retaining means other than an outer sleeve, e.g. male-female connector between stent and instrument
    • A61F2002/9511—Instruments specially adapted for placement or removal of stents or stent-grafts having retaining means other than an outer sleeve, e.g. male-female connector between stent and instrument the retaining means being filaments or wires
    • 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
    • A61F2002/9665—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 with additional retaining means
    • 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
    • A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2220/0075—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements sutured, ligatured or stitched, retained or tied with a rope, string, thread, wire or cable

Definitions

  • FIG. 6 shows the catheter retaining a prosthesis in a collapsed condition prior to deployment, the outer sheath being shown in a position withdrawn from the prosthesis.
  • Fig. 8 is a side view, with portions broken away and in section, of the prosthesis delivery catheter shown in Fig. 7, showing the catheter retaining a prosthesis in a collapsed condition prior to deployment, with the pull wire still advanced to restrain radial expansion of the prosthesis.
  • Fig. 9 is a side view, with portions broken away and in section, of the prosthesis delivery catheter shown in Fig. 8, showing the prosthesis in a radially expanded condition after actuation of the pull wire to remove the restraining means .
  • Fig. 8 is a side view, with portions broken away and in section, of the prosthesis delivery catheter shown in Fig. 8, showing the prosthesis in a radially expanded condition after actuation of the pull wire to remove the restraining means .
  • FIGS. 13A and 13B are simplified side views of the distal end of the prosthesis delivery catheter shown in Fig. 5B, with the outer sheath removed, showing other alternative embodiments of a restraining means for maintaining the releasing means in a desired orientation while retaining the prosthesis in a restrained condition, without reliance upon a tubular sleeve carried by the central shaft .
  • FIGs . 14A and 14B are simplified side views of the distal end of the prosthesis delivery catheter shown in Fig. 5B, with the outer sheath removed, showing other alternative embodiments of a releasing means with a cutting element for selectively releasing the prosthesis for use, together with an associated restraining means for maintaining the releasing means in a desired orientation for operation.
  • Figs. 14A and 14B are simplified side views of the distal end of the prosthesis delivery catheter shown in Fig. 5B, with the outer sheath removed, showing other alternative embodiments of a releasing means with a cutting element for selectively releasing the prosthesis
  • the spacer 30 provides support for the outer sheath 18 and, by occupying space within the outer sheath 18, reduces the amount of air entrapped within the catheter 10.
  • the distal end of the spacer 30 desirably terminates adjacent the proximal end of the prosthesis 14 (as Fig. 5B shows) .
  • the cavity 32 containing the prosthesis 14 extends from the proximal end of the catheter tip component 24 to the distal end of the spacer 30.
  • the spacer 30 is positioned over the central shaft 22 and releasing means 28 and the proximal end of the spacer 30 is connected to the handle assembly 20.
  • the releasing means 28 includes a wire 58 that extends along the central shaft 22.
  • the distal end of the wire 58 passes through the crescent shape lumen 42 of the retaining means 26, and is ultimately captured in the hole or recess 40 of the retaining means 26 in the proximal end of the catheter tip component 24.
  • the distal end of the wire 58 is thereby kept in a desired relationship along the central shaft 22.
  • the proximal end of the wire 58 is coupled to the control button 46, such that fore and aft movement of the button 46 advances the wire 58, respectively, distally and proximally.
  • Fig. 5B shows (and which is further shown in more schematic form in Figs.
  • This design prevents the position of the prosthesis 14 from moving relative to the handle body 52 while the outer sheath 18 is retracted.
  • the sliding knob 50 is moved proximally until the distal end of the outer sheath 18 is free of the prosthesis 14 (see Fig. 8) .
  • the portion or portions of the prosthesis 14 that are not coupled to the releasing means 28 (which, in the illustrated embodiment comprise the proximal region of the prosthesis 14) are free to self-expand, as Fig. 8 shows.
  • the restraining means 26 includes a single tube 80 carried by the central shaft 22, through which the movable component 58 of the releasing means 28 passes.
  • the tube 80 can comprise a surrounding tube of the type shown in Fig. 12A (as Figs. 15A and 15B show) or an external tube of the type shown in Fig. 12B.
  • the releasing means 28 includes a wedge element 84 carried on the distal end of the movable component 58 of the releasing means 28. The wedge element 84 nests within a mating wedge surface 86 formed in the proximal end of the catheter tip component 24.

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)
  • Gastroenterology & Hepatology (AREA)
  • Pulmonology (AREA)
  • Prostheses (AREA)
  • Media Introduction/Drainage Providing Device (AREA)
  • Infusion, Injection, And Reservoir Apparatuses (AREA)
  • Medicines That Contain Protein Lipid Enzymes And Other Medicines (AREA)
PCT/US2004/027587 2003-10-23 2004-08-25 Prosthesis delivery systems and methods Ceased WO2005044073A2 (en)

Priority Applications (8)

Application Number Priority Date Filing Date Title
CN2004800312370A CN1870950B (zh) 2003-10-23 2004-08-25 修补物输送系统和方法
AT04782144T ATE438362T1 (de) 2003-10-23 2004-08-25 Prothesen-ablagesysteme
DK04782144T DK1682039T3 (da) 2003-10-23 2004-08-25 Proteseanbringelsessystemer
DE602004022446T DE602004022446D1 (de) 2003-10-23 2004-08-25 Prothesen-ablagesysteme
AU2004287353A AU2004287353A1 (en) 2003-10-23 2004-08-25 Prosthesis delivery systems and methods
EP04782144A EP1682039B1 (en) 2003-10-23 2004-08-25 Prosthesis delivery systems
JP2006536615A JP4912883B2 (ja) 2003-10-23 2004-08-25 補綴具送達システムおよび補綴具送達方法
CA002539265A CA2539265A1 (en) 2003-10-23 2004-08-25 Prosthesis delivery systems and methods

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US10/692,283 2003-10-23
US10/692,283 US7147657B2 (en) 2003-10-23 2003-10-23 Prosthesis delivery systems and methods

Publications (2)

Publication Number Publication Date
WO2005044073A2 true WO2005044073A2 (en) 2005-05-19
WO2005044073A3 WO2005044073A3 (en) 2006-03-09

Family

ID=34522082

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/US2004/027587 Ceased WO2005044073A2 (en) 2003-10-23 2004-08-25 Prosthesis delivery systems and methods

Country Status (11)

Country Link
US (3) US7147657B2 (enExample)
EP (1) EP1682039B1 (enExample)
JP (2) JP4912883B2 (enExample)
CN (1) CN1870950B (enExample)
AT (1) ATE438362T1 (enExample)
AU (1) AU2004287353A1 (enExample)
CA (1) CA2539265A1 (enExample)
DE (1) DE602004022446D1 (enExample)
DK (1) DK1682039T3 (enExample)
ES (1) ES2356352T3 (enExample)
WO (1) WO2005044073A2 (enExample)

Cited By (9)

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US8080050B2 (en) 2003-07-21 2011-12-20 Aptus Endosystems, Inc. Prosthesis delivery systems and methods
US8231639B2 (en) 2001-11-28 2012-07-31 Aptus Endosystems, Inc. Systems and methods for attaching a prosthesis within a body lumen or hollow organ
US8690897B2 (en) 2001-11-28 2014-04-08 Aptus Endosystems, Inc. Devices, systems, and methods for prosthesis delivery and implantation, including the use of a fastener tool
US9023065B2 (en) 2001-11-28 2015-05-05 Aptus Endosystems, Inc. Devices, systems, and methods for supporting tissue and/or structures within a hollow body organ
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
US9968353B2 (en) 2001-06-04 2018-05-15 Medtronic Vascular, Inc. Catheter based fastener implantation apparatus and methods
US10098770B2 (en) 2001-11-28 2018-10-16 Medtronic Vascular, Inc. Endovascular aneurysm devices, systems, and methods
US10194905B2 (en) 2001-11-28 2019-02-05 Medtronic Vascular, Inc. Devices, systems, and methods for endovascular staple and/or prosthesis delivery and implantation

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US8080050B2 (en) 2011-12-20
US7147657B2 (en) 2006-12-12
CN1870950A (zh) 2006-11-29
EP1682039A2 (en) 2006-07-26
US20070083255A1 (en) 2007-04-12
EP1682039B1 (en) 2009-08-05
WO2005044073A3 (en) 2006-03-09
CN1870950B (zh) 2010-05-26
EP1682039A4 (en) 2007-04-18
JP2010227613A (ja) 2010-10-14
CA2539265A1 (en) 2005-05-19
ES2356352T3 (es) 2011-04-07
DK1682039T3 (da) 2009-11-02
DE602004022446D1 (de) 2009-09-17
JP2007508893A (ja) 2007-04-12
JP4912883B2 (ja) 2012-04-11
AU2004287353A1 (en) 2005-05-19
US20050090834A1 (en) 2005-04-28
ATE438362T1 (de) 2009-08-15
US20120059450A1 (en) 2012-03-08

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