WO2008034793A1 - Dispositif actionneur portatif - Google Patents

Dispositif actionneur portatif Download PDF

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Publication number
WO2008034793A1
WO2008034793A1 PCT/EP2007/059776 EP2007059776W WO2008034793A1 WO 2008034793 A1 WO2008034793 A1 WO 2008034793A1 EP 2007059776 W EP2007059776 W EP 2007059776W WO 2008034793 A1 WO2008034793 A1 WO 2008034793A1
Authority
WO
WIPO (PCT)
Prior art keywords
reel
housing
drive system
tube
trigger
Prior art date
Application number
PCT/EP2007/059776
Other languages
English (en)
Inventor
Jürgen Dorn
Michael Vogel
Martin Wübbeling
Original Assignee
Angiomed Gmbh & Co. Medizintechnik Kg
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 Angiomed Gmbh & Co. Medizintechnik Kg filed Critical Angiomed Gmbh & Co. Medizintechnik Kg
Publication of WO2008034793A1 publication Critical patent/WO2008034793A1/fr

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
    • A61F2/95—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
    • 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

Definitions

  • the present invention relates generally to a device for pulling a wire axially, relative to a tube surrounding the wire. More particularly, but not exclusively, the invention relates to a device that is a sheath retraction system for retracting an outer sheath relative to an inner support catheter and more particularly to a hand-held actuator device of a stent delivery system.
  • Pull wire devices have been proposed for a medical system for delivering a self-expanding stent that is installed in surrounding co-axial engagement at the distal end of a support catheter, the stent being constrained in a reduced-diameter configuration about the catheter by the outer sheath, which surrounds both the stent and catheter.
  • the sheath and catheter are usually sized to be insertable, distal end first, into the bodily lumens of the cardiovascular system, to deliver the stent percutaneously to a treatment site, at which the sheath is withdrawn to release the stent, which expands to a larger diameter configuration to maintain the bodily lumen passageway unobstructed.
  • US 2005/0060016 discloses a delivery system for implantation of a self -expanding medical device in a body which includes a control handle and a catheter portion.
  • the control handle has a rotatable thumbwheel to actuate a retraction mechanism.
  • This retraction mechanism includes a slideable gear rack, which is moved when the thumbwheel is actuated, thereby retracting an outer restraining member like the above mentioned catheter.
  • the outer restraining member includes the self-expanding medical device and an inner catheter member.
  • the gear rack can pull back a length of the outer restraining member not longer than a distance, which is designated for moving the gear rack into the housing, but not exceeding a distance of its length. This is a problem especially for longer medical devices. Therefore, a device like this would have to be built very big for delivering longer medical devices. This would be very obstructive during an operation with such a device.
  • WO 02/087470 discloses a hand device for a catheter stent delivering system.
  • the restraint function Is performed by a hub that is mounted within the hand-held actuator and itself receives the proximal end of the tube.
  • an index ⁇ finger-triggering-system which causes a mechanical apparatus within the device to pull In the outer sheat of a catheter and deliver the stent.
  • index- finger-triggering-system Is that it can only deliver a short stent.
  • the maximum length which can be delivered by successive squeezes of the trigger is defined by the length of the track in the hand unit, rendering it incapable of releasing a self -expanding stent which is longer than the track.
  • WO 2005/039448 discloses an actuator, which can cause relative motion between an inner and an outer tube.
  • the outer tube surrounds the Inner tube so that a medical device can be positioned between the inner and outer tubes.
  • the actuator is formed of a rotatable member having a radius that increases as the actuator rotates. Therefore, the mechanical advantage of the actuator changes, in particular decreases, during the movement of the actuator.
  • the system further includes a windable wire that couples the rotatable member to the outer tube .
  • the first disadvantage of this system is that the mechanical advantage falls progressively.
  • WO 2005/039448 discloses nothing to inhibit reverse motion of the windable member. During actuating the rotatable member the contact between the operator and the actuator is likely to be discontinuous or intermitted and, because a wire has resilience, the system may have a reverse motion of the rotatable member which causes loss of control over the delivering of medical devices.
  • Stents are getting longer.
  • an in the past commonly used self-expanding stent had a length of about 2-3 cm and were delivered only to designated places.
  • Stents are being envisaged which have a length of about 20 cm or more (e.g. a stent for a long artery in the leg) . It is one object of the present invention to provide a hand-held actuator useful for release of a self-expanding stent with a length longer than the known hand-held actuators can handle.
  • Another object of the present invention to provide ways in which the release force and the pull -velocity to which the stent is subject can be adjusted, in dependence upon the nature and characteristics of the medical procedure and prosthesis .
  • the present invention aims to improve on the performance of the devices of WO 02/087470, US 2005/0060016 and WO 2005/039448, in the respects mentioned above.
  • a device for pulling a length of wire out of a tube of the form discussed above and defined in claim 1 below.
  • the preferred use of the device is releasing into the body from a delivery system a medical prosthesis, such as a stent.
  • a medical prosthesis such as a stent.
  • Optional or preferred features of the invention are mentioned in the dependent claims.
  • the device comprises an elongate housing with a distal and a proximal end, a reel mounted in that housing for receiving the length of wire, a first hub mounted on the distal end of the housing for receiving the tube with the wire and reel -drive system for urging the reel to rotate, thereby pulling the length of wire out of the tube.
  • the reel -drive system includes a one-way element that transmits motion/rotation in one direction, and has a lost motion in the converse direction.
  • the reel -drive system further advantageously includes an exposed roller, which may be a thumbwheel, to be contacted by the hand which holds the housing, to impart the manual drive to the reel-drive system.
  • an exposed roller which may be a thumbwheel
  • the reel -drive system includes a latch element which is movable between a first locking and a second release disposition. In the locking disposition the roller is locked against rotation while in the release disposition the roller is free and the latch element does not restrain rotation of the roller.
  • the axis of rotation of the roller is spaced from the axis of rotation of the reel.
  • the reel -drive system includes a drive connection that comprises at least one intermediate element that passes the drive from the roller to the reel.
  • This intermediate element can be a belt that runs between two pulleys and has evenly spaced formations.
  • a complementary series of evenly spaced formations is provided on each of the pulleys. These spaced formations could be raised portions on the belt receiving surfaces of the pulleys, and through apertures on the belt.
  • the intermediate element is a toothed gear or a plurality of toothed gears, arranged in a sequence.
  • These gear wheels can be mounted as a sub-assembly for inclusion in the housing.
  • the sub-assembly can utilise a frame by which it can be mounted within the housing.
  • the device includes further a second hub for the introduction of flushing liquid to the tube that contains the wire that is to be wound on the reel.
  • the housing is defined by two half housings that mate together at a mating line which runs lengthwise of the elongate housing.
  • One reel -drive system can be mounted in one of the half housings prior to mating to one half housing the other of the two half housings.
  • the second reel-drive system can be a trigger system that includes a trigger which is arranged so as to urge the reel to rotate on each squeeze of the trigger. Both systems can be mounted in one of the half housings prior to mating to one half housing the other of the two half housings .
  • the device comprises a reel drive power transmission system that includes a gearbox that enables a switch from one predetermined mechanical advantage to another.
  • a replaceable sub-assembly is provided and in another embodiment, a component such as a trigger can be switched between several rotational axis locations.
  • Fig. 1 shows a longitudinal section of a first preferred embodiment
  • Fig. 2 shows a longitudinal section of a second preferred embodiment
  • Fig. 3 shows a section along the line III- III in Fig 1;
  • Fig. 4 shows a section along the line IV-IV in Fig 3;
  • the invention can be embodied in a device for pulling a wire out of a tube and which can be activated manually, preferably with only one hand.
  • the device has a moulded, elongate housing 10 in two halves.
  • the housing serves both as a frame for mounting the inner components of the device and as a hand grip.
  • the housing has a distal end 12 and a proximal end 14.
  • a portion shaped to be gripped in a hand is covered by a grip- improving rubber material (not shown) .
  • the housing halves are fixed together at a mating line which runs lengthwise of the elongate housing. This can be with adhesive bonding or, alternatively or commutatively at designated places 16 with screws, rivets or plugs.
  • a first hub 20 acting as an abutment and bearing element for setting the spacial relationship between the outer tube (not shown) and the housing 10 and to separate axial movement of the wire 8 from the axial position of the tube.
  • the outer tube defines a lumen that possibly includes an inner tube 9 which extends to a second hub 22 at the proximal end 14 of the housing 10.
  • the second hub 22 provides a female luer connector to engage a corresponding male luer, for flushing liquid directly for the lumen of the inner tube 9, but finally the liquid flushes into the lumen of the outer tube .
  • a reel 24 (Fig. 2) is mounted rotatably in the housing 10 to take up the wire 8 by rotating and thereby coiling up the wire 8.
  • the reel 24 can be made to rotate by a reel -drive system, which can be provided according to different embodiments as described below.
  • a ball- end on the wire 8 and a first and second borehole 26, 27 in the reel 24 there is provided a ball- end on the wire 8 and a first and second borehole 26, 27 in the reel 24. Both boreholes 26, 27 are nearly radial with a slightly incline to the rotatory axis of the reel 24. Further there is a groove 28 circular in the middle of the reel 24 transverse to the rotatory axis co-axial with the borehole 26.
  • the end of the wire 8 carries a sleeve and a ball welded to the end of the wire 8.
  • the wire 8 is put with the free end into the sleeve and the ball stops the wire 8 from sliding through the sleeve. Another way fixing the sleeve to the wire 8 could be to weld the ball on the wire 8 after putting it through the sleeve.
  • the wire 8 and the sleeve are pressed together such the sleeve is fixed on the wire 8.
  • the wire 8 is threaded into the groove 28 into the second borehole 27 and the sleeve is advanced into the first borehole 26. Pulling the wire 8 urges the sleeve to slide into the borehole 26, which has a diameter slightly bigger than the sleeve, and blocks the wire 8 from being pulled further.
  • the reel 24 has teeth 30 formed respectively as two adjacent spikes divided by the groove 28. These spikes are shaped vertical on the outer side, but inclined to the middle of the reel 24 so as to urge the wire 8 to slip into the groove 28.
  • a detent 32 (a backstroke stopper) that serves to inhibit reverse rotation of the reel is provided near the reel 24.
  • the detent 32 engages the teeth 30 of the reel 24 and prevents it from rotating backwards again, so as to keep the wire 8 tight.
  • the teeth 30 of the reel 24 are formed such that the detent 32 does not prevent the reel from rotating in one direction (e.g. direction A in Fig. 2) , but stops the reel 24 rotating in the other direction.
  • a reel -drive system is provided.
  • this reel -drive system is manually driven, so that it must have an interface to the operator.
  • the motion axis of this interface e.g. a roller
  • the reel- drive system comprises means to switch between predetermined mechanical advantages. This can be changing of a sub-assembly that works as a gearbox in the power transmission module for driving the reel .
  • the reel -drive system is a roller-system which comprises a roller 34 that is preferably a thumbwheel, a roller release element 36, an intermediate element between the roller 34 and the reel 24, a toothed wheel 38 and a one-way transmission 40 that utilises for example a slip clutch such as one based on a needle roller bearing.
  • the roller 34 is mounted in the housing 10 and a portion of the roller 34 protrudes out of the housing 10.
  • the roller 34 Is either integrally fixed or otherwise connected to a first toothed wheel 42. In an initial position the roller 34 is blocked from rotating by a roller release element 36, which can be regarded as something in the nature of a safety catch.
  • the release element 36 is an elongation with a distal end 41 and a proximal end 43 and serves as a latch. In a first position, a locking disposition, the distal end 41 of the elongation is plugged In a corresponding hole 45 in the roller 34. Near the proximal end 43 of the elongation a button 46 is provided.
  • the button 46 has an upper side which protrudes through an opening of the housing, and a lower side that is preferably integrally fixed on the elongation.
  • a spring element 54 is mounted on a plate 50 which Is integrally formed with the housing 10. The spring element 54 is either fixed on the plate 50, e.g.
  • a small knob 52 On the proximal end of the elongation is a small knob 52.
  • the knob 52 In the first position of the roller release element 36, the knob 52 protrudes In the opening, touches the inner wall of the opening and prevents the release element 36 from sliding.
  • the button 46 together with the knob 52 and the spring element 48 are pressed down .
  • the knob 52 moves into the hous ing 10 beneath the inside wall and allows the release element 36 to sl ide .
  • the drive wheel 38 is connected by a one-way transmi ss ion 40 to the reel 24 and transmits the rotation .
  • the one -way transmission is preferably an overtake- clutch ( otherwi se called a slip clutch) .
  • Such clutches are known per se .
  • the intex"mediate element is a sub-assern-bly that comprises at least one toothed wheel (otherwise called gear) or a plurality of toothed wheels 55, 56a, 56b, 57 which are mounted in sequence on a frame 58 providing as gear trains with different transmission or gear ratios.
  • the frame 58 is plugged with at least one aperture 60 on at least one plug (not shown) in the housing.
  • This interface on the frame between the sub-assembly and the housing allows using a sub-assembly with a mechanical advantage (in this case the ratio of the toothed wheels 55, 56a, 56b, 57) as needed. I.e. it is possible to choose between alternative mechanical advantages differing in steps by using the suitable power transmission module.
  • the frame 58 preferably comprises two side plates which are connected by bearings 62 for the toothed wheels 55, 56a, 56b, 57.
  • the side plate adjacent to the housing has the at least one aperture 60 o plug the frame on the housing 10.
  • On a bearing 62 are espectively mounted either one 57 or two 56a, 56b toothed wheels 56a, 56b. One of them (56a) is driven by the adjacent wheel (not shown, behind 55) in the sequence, the other wheel (e.g. 56b) drives the following wheel (57) .
  • the illustrated embodiment are provided three bearings for the wheels. This enables the sub-assembly to provide a wide scope of different mechanical advantages.
  • the chosen power transmission module can provide a predetermined user-defined gear ratio that can be selected to achieve a desired mechanical advantage or rate of coiling up the wire 8 on the reel 24.
  • the number of bearings for the toothed wheels in the gear is preferably odd, so that the reel 24 rotates in the same direction as the roller 34.
  • the gear sequence is replaced by a belt.
  • the wheel adjacent to the roller and the wheel adjacent to the reel are replaced by two wheels that are pulleys.
  • raised portions e.g. knobs
  • Belts require only little space and provide simultaneously a good transmission of force.
  • the reel-drive system comprises a Finger-Trigger-System which comprises a trigger 70, a trigger release element 72, an intermediate element, preferably a toothed elongation 74, a return element 76, preferably a spring-force-return element with linear springs and a toothed wheel 78 on a one-way transmission 80.
  • the device can offer the operator more than one way to drive the reel.
  • the device can have both a thumb wheel and a trigger, to drive a single reel .
  • the release element 72 is an elongation with a blocked end 82 which intrudes in a corresponding hole 83 in the trigger 70, a free end 84 which is in a first position adjacent to a small wall 86 and a button 88 on the elongation that protrudes outwards the housing for being pressed.
  • a spring element 90 is provided between the release element 72 and a plate 92 that is integrally formed with and protrudes from the housing 10.
  • the release element 72 has to be moved from a first initial position to a second position.
  • the button 88 has to be pushed down against the spring force of the spring element 90 thereby lifting the free end 84 over the wall 86.
  • the release element 72 can be pushed and slides in a second position pulling the blocked end 82 out of the hole 83 and freeing the trigger 70.
  • the trigger 70 has a rotating movement around his bearing 91.
  • an intermediate element as a power transmission module for transmitting the power from the trigger to the reel.
  • the power transmission module is a toothed elongation 74 which is formed as a ratchet or as an arcuate shaped elongation that can be more particular a planetary gear portion with involute teeth.
  • the elongation is integrally moulded with the trigger (shown in Fig. 2) .
  • This trigger including the power transmission module corresponds to the sub-assembly of the first embodiment. It can be replaced by another trigger.
  • the trigger provides different predetermined slots 73 or plug- in places where the elongation 74 can be fixed onto the trigger. These slots 73 serve as relative rotational axis of the elongation 74. This allows changing the mechanical advantage as it is needed. If the elongation 74 is near the rotational axis 91 of the trigger, the mechanical advantage is bigger, the pull-length shorter. The further from the rotational axis 91 the elongation 74 is fixed, the more length of wire 8 is pulled in by triggering, but the less mechanical advantage is provided. In this case only the intermediate element 74 corresponds to the sub- assembly of embodiments 1 or 2 and provides the same advantages of adjusting the mechanical advantage. I.e. it is possible to change the mechanical advantage stepwise by choosing the suitable lever ratio of the relative rotational axis 73 of the elongation in view of the rotational axis 91 of the trigger 70.
  • the trigger When the trigger is freed it can be pushed and the toothed elongation urges a toothed wheel 78 adjacent to the reel 24 to rotate.
  • a one-way element SO the rotation is transferred to the reel.
  • the one-way element can be a one way bearing as well as an overtake-clutch like in the roller-based embodiment or any other one-way transmission.
  • the teeth of the elongation 74 and the toothed wheel 78 can be shaped similar like the teeth 30 of the reel 24, so that they transmit force in direction A and slip over in the reverse direction.
  • the elongation is built as a planetary gear portion ⁇ arcuate shaped) with involute teeth.
  • the corresponding toothed wheel then has also involute teeth.
  • a plate 94 integrally moulded in the housing 10 is arranged adjacent and parallel to the elongation 74 of the trigger 70.
  • One or more linear springs 76 are fixed on one end of the plate 94, preferably with a bolt 96 integrally moulded in the housing 10.
  • the at least one linear spring 76 is also fixed on the end of the elongation 74, preferably on a bolt 98 integrally moulded in the elongation 74.
  • two reel -drive systems can be assembled, one respectively for each half housing.
  • the reel- drive systems of the first and the second embodiment could be provided together, one in each of the two halves of the housing, and both operating on the same single reel.
  • roller-based reel- drive system could facilitate a stronger slow release option by a gear ratio of 1:4 what may be 6 mm per roll, and the trigger-based reel -drive system could facilitate a weaker fast release option of 1:2 what may be 12 mm per squeeze/pump of the trigger. If one reel-drive system is actuated, the other runs free, because of its one-way transmission.
  • the hand unit can release a prosthesis of any length.
  • the features of the illustrated embodiments are available for inclusion in other embodiments differing from the illustrated, as the skilled reader will appreciate.
  • the invention is defined in the claims and the illustrated embodiments are exemplary.

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)

Abstract

L'invention concerne un dispositif pour tirer une longueur de fil métallique par rapport à un tube entourant le fil métallique (8) à l'extérieur du tube, comportant un boîtier (10) ayant une extrémité distale et une extrémité proximale, une bobine (24) montée dans le boîtier pour recevoir la longueur de fil métallique (8) et un système d'entraînement de bobine pour solliciter la bobine à ramener la longueur de fil métallique à l'extérieur du tube, ce par quoi le système d'entraînement de bobine comprend un élément unidirectionnel (32).
PCT/EP2007/059776 2006-09-20 2007-09-17 Dispositif actionneur portatif WO2008034793A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
GBGB0618516.9A GB0618516D0 (en) 2006-09-20 2006-09-20 Hand-held actuator device
GB0618516.9 2006-09-20

Publications (1)

Publication Number Publication Date
WO2008034793A1 true WO2008034793A1 (fr) 2008-03-27

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Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/EP2007/059776 WO2008034793A1 (fr) 2006-09-20 2007-09-17 Dispositif actionneur portatif

Country Status (2)

Country Link
GB (1) GB0618516D0 (fr)
WO (1) WO2008034793A1 (fr)

Cited By (26)

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WO2009007432A1 (fr) * 2007-07-11 2009-01-15 Angiomed Gmbh & Co. Medizintechnik Kg Dispositif de rétraction d'une gaine de cathéter
US7935141B2 (en) 2005-08-17 2011-05-03 C. R. Bard, Inc. Variable speed stent delivery system
US8062344B2 (en) 2001-04-30 2011-11-22 Angiomed Gmbh & Co. Medizintechnik Kg Variable speed self-expanding stent delivery system and luer locking connector
WO2011163386A1 (fr) * 2010-06-24 2011-12-29 Cordis Corporation Appareil et procédé destinés à tirer un élément de traction d'un dispositif médical
CN102821719A (zh) * 2010-03-30 2012-12-12 泰尔茂株式会社 支架输送系统
US8808346B2 (en) 2006-01-13 2014-08-19 C. R. Bard, Inc. Stent delivery system
US9078779B2 (en) 2006-08-07 2015-07-14 C. R. Bard, Inc. Hand-held actuator device
WO2015134917A3 (fr) * 2014-03-06 2015-12-03 W.L. Gore & Associates, Inc. Appareil de déploiement et de contrainte de dispositifs médicaux implantables
WO2016043860A1 (fr) * 2014-09-15 2016-03-24 Cook Medical Technologies Llc Système de pose de dispositif d'intervention vasculaire actionné par cliquet
USD786429S1 (en) 2015-09-04 2017-05-09 Cook Medical Technologies Llc Handle for thumbwheel actuated medical stent delivery device
USD795425S1 (en) 2015-08-12 2017-08-22 Cook Medical Technologies Llc Ratchet pawl for thumbwheel actuated stent delivery system
US9801745B2 (en) 2010-10-21 2017-10-31 C.R. Bard, Inc. System to deliver a bodily implant
US9974677B2 (en) 2013-08-20 2018-05-22 Cook Medical Technologies Llc Wire collection device for stent delivery system
US9974676B2 (en) 2013-08-09 2018-05-22 Cook Medical Technologies Llc Wire collection device with geared advantage
US9974678B2 (en) 2014-03-10 2018-05-22 Cook Medical Technologies Llc Wire collection device with varying collection diameter
US10307276B2 (en) 2016-07-18 2019-06-04 Cook Medical Technologies Llc Pistol stent delivery device and method of operating same
US10441449B1 (en) 2018-05-30 2019-10-15 Vesper Medical, Inc. Rotary handle stent delivery system and method
US10449073B1 (en) 2018-09-18 2019-10-22 Vesper Medical, Inc. Rotary handle stent delivery system and method
EP3578143A4 (fr) * 2016-12-30 2020-12-30 Seven Sons Ltd. R.N. 515985570 (The "Company") Dispositif et procédé de positionnement précis sans danger d'un stent coronaire dans des artères coronaires
US10959868B2 (en) 2014-09-15 2021-03-30 Cook Medical Technologies, LLC Ratchet operated vascular intervention device delivery system
US11026822B2 (en) 2006-01-13 2021-06-08 C. R. Bard, Inc. Stent delivery system
US11166806B2 (en) 2014-01-10 2021-11-09 W. L. Gore & Associates, Inc. Implantable intraluminal device
US11219541B2 (en) 2020-05-21 2022-01-11 Vesper Medical, Inc. Wheel lock for thumbwheel actuated device
US11229539B2 (en) 2011-08-12 2022-01-25 W. L. Gore & Associates, Inc. Evertable sheath devices, systems, and methods
US11540933B2 (en) 2017-10-11 2023-01-03 W. L. Gore & Associates, Inc. Implantable medical device constraint and deployment apparatus
US11903856B1 (en) 2013-03-05 2024-02-20 W. L. Gore & Associates, Inc. Tapered sleeve

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