APPARATUS AND METHODS FOR DEPLOYMENT OF LINKED PROSTHETIC SEGMENTS

Abstract

A luminal prosthesis comprises a plurality of radially expandable prosthetic stent segments arranged axially. Two or more of the prosthetic stent segments are separable upon expansion from the remaining prosthetic stent segments and a coupling structure connects at least some of the adjacent prosthetic stent segments to each other. The coupling structure permits a first group of the adjacent prosthetic stent segments to separate from a second group of the prosthetic stent segments upon differential radial expansion of the first group relative to the second group and the coupling structure maintains or forms an attachment between the adjacent prosthetic stent segments in the first group which have been expanded together. A delivery system and methods for deploying the multiple coupled prosthetic stent segments are also disclosed.

Description

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 shows a perspective view of a luminal prosthesis delivery system composed of multiple linked stents arranged axially along a delivery catheter.

FIG. 2A is a side view of a luminal prosthesis delivery system with multiple linked stents mounted on a delivery catheter and positioned in a vessel, at a target lesion site.

FIG. 2B is a side view illustrating a group of stent segments selected for deployment.

FIG. 2C is a side view illustrating the stent segments selected for deployment separated from the remaining stent segments.

FIG. 2D is a side view illustrating the selected stent segments radially expanded while the remaining stent segments are left behind on the delivery catheter.

FIG. 3 shows two stent segments coupled together with magnets.

FIG. 4A shows stent segments coupled together by overlapping stent segment ends.

FIG. 4B illustrates stent segment ends that overlap smoothly.

FIG. 4C illustrates stent segments coupled with overlapping arch shaped stent segment ends.

FIG. 4D shows stent segment ends that couple together by mating a raised surface with a corresponding depressed surface.

FIG. 5 shows balloon inflation breaking the coupling structure between stent segments.

FIG. 6A shows a luminal prosthesis comprised of stent segments coupled together with a strand of material. A cutting mechanism on the delivery catheter severs the coupling structure.

FIG. 6B shows a similar luminal prosthesis as in FIG. 6A, with an alternative cutting mechanism.

FIG. 6C shows a luminal prosthesis with a coupling structure comprised of a series of axially oriented loops of material between adjacent stent segment ends.

FIG. 6D shows the luminal prosthesis of FIG. 6C highlighting the coupling structure.

FIG. 6E shows another luminal prosthesis with a coupling structure comprised of a single strand of material circumferentially threaded through adjacent stent segment ends.

FIG. 6F shows the luminal prosthesis of FIG. 6E highlighting the coupling structure.

FIG. 7A shows a luminal prosthesis delivery system with a movable coupling structure.

FIG. 7B shows the luminal prosthesis delivery system of FIG. 7A with some of the coupling structures closed.

FIG. 7C shows a luminal prosthesis delivery system with an active closing element that closes the coupling structure between stent segments.

FIG. 7D shows a luminal prosthesis delivery system where an active closing element reflows an adhesive between adjacent stent segments.

FIG. 7E shows the coupling structure formed when an active closing element reflows adhesive between adjacent stent segment ends.

FIG. 7F further illustrates how a coupling structure may be formed when an active closing element reflows adhesive between adjacent stent segment ends.

FIG. 8A shows a luminal prosthesis delivery system where the coupling elements are closed by balloon inflation.

FIG. 8B shows how the coupling elements of FIG. 8A engage upon balloon inflation.

FIG. 8C illustrates another geometry where coupling elements engage during balloon inflation.

FIG. 8D shows yet another geometry where coupling elements engage during balloon inflation.

FIG. 8E is a side view of the coupling elements when they are engaged.

FIG. 8F is a top view of hook shaped coupling elements when engaged.

FIG. 8G shows another geometry of coupling elements adapted to engage during balloon inflation.

FIG. 8H illustrates a stent delivery catheter having multiple expandable members adapted to selectively interlock stent segments together.

FIG. 8I illustrates multiple inflation lumens used to selectively inflate the expandable members of FIG. 8H.

FIG. 9A shows a luminal prosthesis delivery system with releasable couplings in between stent segments.

FIG. 9B shows a possible geometry of the coupling structure in FIG. 9A.

FIG. 9C shows another geometry of the coupling structure in FIG. 9A.

FIG. 10A shows a luminal prosthesis wherein the coupling structure between adjacent stent segments is decoupled by balloon inflation.

FIG. 10B shows one embodiment of the coupling structure of FIG. 10A where overlapping stent ends interlock.

FIG. 10C shows a protuberance on one stent segment end that can form a part of the coupling structure of FIG. 10A.

FIG. 10D shows an alternative embodiment of the coupling structure of FIG. 10A wherein an adhesive couples adjacent stent segment ends together.

FIG. 10E shows the adhesive of FIG. 10D, applied to one stent segment end.

FIG. 11A shows a releasable coupling structure between adjacent stent segment ends.

FIG. 11B shows an alternative embodiment of the releasable coupling structure of FIG. 11A.

FIG. 11C illustrates overlapping stent segment ends that have the releasable coupling structure of FIG. 11A.

FIG. 11D shows a ball-socket coupling structure that may be employed as the coupling structure in FIG. 11A.

FIG. 11E shows interleaving struts that may be employed as the coupling structure in FIG. 11A.

FIG. 11F shows mating hooks which may be employed as the coupling structure in FIG. 11A.

FIGS. 11G-11H show another embodiment of a releasable coupling structure.

FIG. 12A illustrates an inflatable decoupling element.

FIG. 12B shows overlapping stent segment ends releasably coupled.

FIG. 12C is a cross-sectional view of overlapping stent segment ends in FIG. 12B.

FIG. 12D illustrates breakable chain linked coupling elements between stent segments.

FIG. 12E illustrates an adhesive coupling element between stent segments.

FIG. 12F shows a hook/ring coupling element between stent segments.

FIG. 12G shows mating hooks coupling stent segments together.

FIGS. 12H-12L show various geometries of interlocking stent segment ends.

FIG. 13A shows stent segments rotationally coupled together.

FIG. 13B shows stent segment ends with hook features that may be rotationally coupled together.

FIG. 14A shows stent segments coupled together with a coating layer.

FIG. 14B shows the coupling between stent segments in FIG. 14A broken by balloon inflation.

FIGS. 15A-15B show a liquid bonding material used to create a coupling structure between stent segments.

FIG. 16A illustrates how self-expanding connecting rings may be used to couple stent segments together.

FIG. 16B shows self-expanding connecting rings linked to balloon expandable stent segments.

FIG. 16C shows a series of self-expanding connecting rings coupled to stent segments.

FIG. 17A shows a heating element used to decouple adjacent stent segments from one another.

FIG. 17B shows adjacent stent segments coupled together with a thermal shape memory alloy or polymer coupling element.

FIGS. 17C-17D show alternative geometries of thermal shape memory alloy coupling elements.

FIG. 17E shows a stent segment with thermal shape memory loops and hooks.

FIG. 18 shows stent segments welded/bonded together after deployment.

Claims

1. A method for delivering a luminal prosthesis to at least one treatment site, the method comprising: providing a plurality of radially expandable prosthetic stent segments arranged axially along a delivery catheter, wherein at least some adjacent prosthetic stent segments have a coupling structure therebetween;positioning the delivery catheter at a first treatment site;selecting two or more prosthetic stent segments for deployment; andradially expanding the selected two or more prosthetic stent segments without expanding the remaining prosthetic stent segments, wherein the coupling structure permits the selected prosthetic stent segments to separate from the remaining prosthetic stent segments while maintaining or forming an attachment between the selected prosthetic stent segments when expanded.

2. The method of claim 1, wherein the coupling structure comprises magnets.

3. The method of claim 1, wherein the coupling structure comprises adjacent prosthetic stent segments with overlapping prosthetic stent segment ends.

4. The method of claim 3, wherein the overlapping prosthetic stent segment ends are held together by friction or by compression.

5. The method of claim 3, wherein the overlapping prosthetic stent segment ends overlap smoothly.

6. The method of claim 3, wherein the overlapping prosthetic stent segment ends interlock with each other.

7. The method of claim 3, wherein the overlapping prosthetic stent segment ends couple by mating a raised surface on one prosthetic stent segment end with a corresponding depressed surface on an adjacent prosthetic stent segment end.

8. The method of claim 1, wherein the coupling structure is broken by inflation of a balloon, permitting a first group of the prosthetic stent segments to separate from a second group of the prosthetic stent segments upon differential radial expansion of the first group relative to the second group and the coupling structure maintains an attachment between adjacent prosthetic stent segments in the first group which have been expanded together.

9. The method of claim 1, wherein the coupling structure comprises a strand of material between adjacent prosthetic stent segments.

10. The method of claim 9, wherein the coupling structure is separated with a cutting device or by applying energy.

11. The method of claim 1, wherein the coupling structure comprises a plurality of strands of material, axially oriented between adjacent prosthetic stent segments.

12. The method of claim 11, wherein the coupling structure is separated with a cutting device or by applying energy.

13. The method of claim 1, wherein the coupling structure extends axially between adjacent prosthetic stent segment ends and is movable between an open position and a closed position, the prosthetic stent segments being coupled together when the coupling structure is in the closed position, wherein upon deployment the coupling structure is moved from the open position to the closed position.

14. The method of claim 13, wherein the coupling structure is moved prior to expansion of the prosthetic stent segments.

15. The method of claim 1, wherein the coupling structure is lockable under tension and releasable under compression.

16. The method of claim 15, further comprising applying tension to a distal most prosthetic stent segment with a structure disposed near a distal end of the delivery catheter.

17. The method of claim 1, wherein the coupling structure comprises a protuberance and a mating recess releasable during catheter balloon inflation.

18. The method of claim 1, wherein the coupling structure comprises a deflectable portion and a coupling portion, wherein deflection of the deflectable portion releases the coupling portion from the adjacent prosthetic stent segments.

19. The method of claim 1, wherein the coupling structure is rotationally lockable.

20. The method of claim 1, wherein the coupling structure comprises a coating across adjacent prosthetic stent segment ends.

21. The method of claim 20, wherein the coating layer is a polymer.

22. The method prosthesis of claim 20, wherein the coating layer is biodegradable.

23. The method prosthesis of claim 20, wherein the coating layer is polylactic acid.

24. The method of claim 20, wherein the coating layer is perforated.

25. The method of claim 20, wherein the coating layer is breakable.

26. The method of claim 1, wherein the coupling structure comprises a liquid bonding material dispensed by the delivery catheter.

27. The method of claim 1, wherein the coupling structure comprises a self-expanding link.

28. The method of claim 1, wherein the coupling structure is composed of a thermal shape memory alloy or a polymer, the structure activated to expand by causing a temperature change.

29. The method of claim 1, wherein the coupling structure couples the adjacent prosthetic stent segments together after expansion of the prosthetic stent segments.

30. The method of claim 29, wherein the coupling structure comprises a bonding material applied between or across adjacent prosthetic stent segments, the bonding material solidifying after expansion of the prosthetic stent segments.

31. A luminal prosthesis comprising: a plurality of radially expandable prosthetic stent segments arranged axially, wherein a group of two or more adjacent prosthetic stent segments is separable upon expansion from the remaining prosthetic stent segments; anda coupling structure between at least some of the adjacent prosthetic stent segments for limiting relative axial movement therebetween, wherein the coupling structure permits a first group of the adjacent prosthetic stent segments to separate from a second group of the prosthetic stent segments upon differential radial expansion of the first group relative to the second group and the coupling structure maintains or forms an attachment between the adjacent prosthetic stent segments in the first group which have been expanded together.

32. The luminal prosthesis of claim 31, wherein the coupling structure permanently couples the adjacent prosthetic stent segments.

33. The luminal prosthesis of claim 31, wherein the coupling structure couples the adjacent prosthetic stent segments long enough to permit endothelialization of the expanded prosthetic stent segments.

34. The luminal prosthesis of claim 31, wherein the coupling structure comprises magnets.

35. The luminal prosthesis of claim 31, wherein the coupling structure comprises adjacent prosthetic stent segments with overlapping prosthetic stent segment ends.

36. The luminal prosthesis of claim 35, wherein the overlapping prosthetic stent segment ends overlap smoothly.

37. The luminal prosthesis of claim 35, wherein the overlapping prosthetic stent segment ends interlock with each other.

38. The luminal prosthesis of claim 35, wherein the overlapping prosthetic stent segment ends couple by mating a raised surface on one prosthetic stent segment end with a corresponding depressed surface on an adjacent prosthetic stent segment end.

39. The luminal prosthesis of claim 31, wherein the coupling structure is broken by inflation of a balloon, permitting a first group of the prosthetic stent segments to separate from a second group of the prosthetic stent segments upon differential radial expansion of the first group relative to the second group and the coupling structure maintains an attachment between adjacent prosthetic stent segments in the first group which have been expanded together.

40. The luminal prosthesis of claim 31, wherein the coupling structure comprises a strand of material between adjacent prosthetic stent segments.

41. The luminal prosthesis of claim 31, wherein the coupling comprises a plurality of strands of material, axially oriented between adjacent prosthetic stent segments.

42. The luminal prosthesis of claim 31, wherein the coupling structure extends axially between adjacent prosthetic stent segment ends and is movable between an open position and a closed position, the prosthetic stent segments being coupled together when the coupling structure is in the closed position, wherein upon deployment the coupling structure is moved from the open position to the closed position.

43. The luminal prosthesis of claim 42, wherein the coupling structure is moved prior to expansion of the prosthetic stent segments.

44. The luminal prosthesis of claim 31, wherein the coupling structure is lockable under tension and is releasable under compression.

45. The luminal prosthesis of claim 31, wherein the coupling structure comprises a protuberance and a mating recess.

46. The luminal prosthesis of claim 31, wherein the coupling structure comprises a deflectable portion and a coupling portion, wherein deflection of the deflectable portion releases the coupling portion from the adjacent prosthetic stent segments.

47. The luminal prosthesis of claim 31, wherein the coupling structure is rotationally lockable.

48. The luminal prosthesis of claim 31, wherein the coupling structure comprises a coating across adjacent prosthetic stent segment ends.

49. The luminal prosthesis of claim 48, wherein the coating layer is a polymer.

50. The luminal prosthesis of claim 48, wherein the coating layer is biodegradable.

51. The luminal prosthesis of claim 48, wherein the coating layer is polylactic acid.

52. The luminal prosthesis of claim 48, wherein the coating layer is perforated.

53. The luminal prosthesis of claim 48, wherein the coating layer is breakable.

54. The luminal prosthesis of claim 31, wherein the coupling structure comprises a liquid bonding material.

55. The luminal prosthesis of claim 31, wherein the coupling structure comprises a self-expanding link.

56. The luminal prosthesis of claim 31, wherein the coupling structure is composed of a thermal shape memory alloy, activated to expand by causing a temperature change.

57. The luminal prosthesis of claim 31, wherein the coupling structure is welded across adjacent prosthetic stent segments after expansion of the prosthetic stent segments.

58. The luminal prosthesis of claim 31, wherein the coupling structure comprises adjacent prosthetic stent segments bonded together after expansion of the prosthetic stent segments.

59. A luminal prosthesis comprising: a plurality of radially expandable prosthetic stent segments arranged axially wherein a group of two or more adjacent prosthetic stent segments is separable upon expansion from the remaining prosthetic stent segments; anda breakable coupling structure between at least some of the adjacent prosthetic stent segments for limiting relative axial movement therebetween, the coupling structure permitting a first group of the adjacent prosthetic stent segments to separate from a second group of the prosthetic stent segments upon differential radial expansion of the first group relative to the second group and the coupling structure maintains an attachment between adjacent prosthetic stent segments in the first group which have been expanded together.

60. The luminal prosthesis of claim 59, wherein the coupling structure is comprises a breakable link extending between adjacent prosthetic stent segments.

61. The luminal prosthesis of claim 59, wherein the coupling structure comprises a polymer layer between or across adjacent prosthetic stent segments.

62. The luminal prosthesis of claim 59, wherein the coupling structure is bioerodable.

63. A luminal prosthesis comprising: a plurality of radially expandable prosthetic stent segments arranged axially, wherein a group of two or more adjacent prosthetic stent segments is separable upon expansion from the remaining prosthetic stent segments; anda coupling structure between at least some of the adjacent prosthetic stent segments for limiting relative axial movement therebetween, wherein the coupling structure comprises a strand of flexible material, the prosthetic stent segments each having a wall with openings therein, the coupling structure being threaded through the openings in the adjacent prosthetic stent segments,wherein severing the coupling structure permits a first group of the adjacent prosthetic stent segments to separate from a second group of the prosthetic stent segments upon differential radial expansion of the first group relative to the second group and the coupling structure maintains an attachment between adjacent prosthetic stent segments in the first group which have been expanded together.

64. The luminal prosthesis of claim 63, wherein the coupling structure is threaded axially through the openings.

65. The luminal prosthesis of claim 63, wherein the coupling structure is threaded circumferentially through the openings.

66. The luminal prosthesis of claim 64, wherein the flexible strand of material comprises a polymer thread.

67. A luminal prosthesis comprising: a plurality of radially expandable prosthetic stent segments arranged axially, wherein a group of two or more adjacent prosthetic stent segments is separable upon expansion from the remaining prosthetic stent segments; anda coupling structure between at least some of the adjacent prosthetic stent segments for limiting relative axial movement therebetween, wherein the coupling structure comprises a deflectable portion and a coupling portion, wherein deflection of the deflectable portion releases the coupling portion from the adjacent prosthetic stent segments.

68. The luminal prosthesis of claim 67, wherein the deflectable portion is actively deflected.

69. The luminal prosthesis of claim 67, wherein the coupling structure comprises mating circular ends.

70. The luminal prosthesis of claim 67, wherein the coupling structure comprises a ball and socket.

71. The luminal prosthesis of claim 67, wherein the coupling structure comprises interleaving ends.

72. The luminal prosthesis of claim 67, wherein the coupling structure comprises mating hooks.

73. A luminal prosthesis comprising: a plurality of radially expandable prosthetic stent segments arranged axially, wherein a group of two or more adjacent prosthetic stent segments is separable upon expansion from the remaining prosthetic stent segments; anda coupling structure between at least some of the adjacent prosthetic stent segments, wherein the coupling structure comprises a coating layer across adjacent prosthetic stent segments, permitting a first group of the adjacent prosthetic stent segments to separate from a second group of the prosthetic stent segments upon differential radial expansion of the first group relative to the second group and the coupling structure maintains an attachment between adjacent prosthetic stent segments in the first group which have been expanded together.

74. The luminal prosthesis of claim 73, wherein the coating layer is a polymer.

75. The luminal prosthesis of claim 73, wherein the coating layer is biodegradable.

76. The luminal prosthesis of claim 73, wherein the coating layer is polylactic acid.

77. The luminal prosthesis of claim 73, wherein the coating layer is perforated between the prosthetic stent segments.

78. The luminal prosthesis of claim 73, wherein the coating layer is breakable.

79. The luminal prosthesis of claim 73, wherein the coating layer is meltable.

80. The luminal prosthesis of claim 73, wherein the coating layer extends over substantially all of an outer surface of the prosthetic stent segments.

81. The luminal prosthesis of claim 73, wherein the coating layer carries a therapeutic agent.

82. A luminal prosthesis delivery system comprising: a delivery catheter having a proximal end and a distal end;a plurality of radially expandable prosthetic stent segments arranged axially near the distal end of the delivery catheter, wherein a group of two or more adjacent prosthetic stent segments is separable upon expansion from the remaining prosthetic stent segments; anda coupling structure between at least some of the adjacent prosthetic stent segments, wherein the coupling structure permits a first group of the adjacent prosthetic stent segments to separate from a second group of the prosthetic stent segments upon differential radial expansion of the first group relative to the second group and the coupling structure maintains an attachment between adjacent prosthetic stent segments in the first group which have been expanded together.

83. The luminal prosthesis delivery system of claim 82, further comprising a balloon disposed on the distal end of the delivery catheter.

84. The luminal prosthesis delivery system of claim 83, wherein the coupling structure is broken by inflation of the balloon, permitting a first group of the prosthetic stent segments to separate from a second group of the prosthetic stent segments upon differential radial expansion of the first group relative to the second group.

85. The luminal prosthesis delivery system of claim 82, wherein the coupling structure comprises a flexible strand of material between the adjacent prosthetic stent segments.

86. The luminal prosthesis delivery system of claim 85, wherein the adjacent prosthetic stent segments each have a wall with openings therein, the flexible strand of material being threaded through the openings.

87. The luminal prosthesis delivery system of claim 85, wherein the flexible strand of material comprises a polymer thread.

88. The luminal prosthesis delivery system of claim 85, further comprising a cutting mechanism, wherein the cutting mechanism severs the strand.

89. The luminal prosthesis delivery system of claim 88, wherein the cutting mechanism severs the strand by application of energy to the coupling structure.

90. The luminal prosthesis delivery system of claim 82, further comprising a closing element near the distal end of the delivery catheter, wherein the coupling structure extends between adjacent prosthetic stent segments and is movable between an open position and a closed position, the prosthetic stent segments being coupled together when the coupling structure is in the closed position, wherein the closing element engages the coupling structure to move the coupling structure from the open position to the closed position.

91. The luminal prosthesis delivery system of claim 90, wherein the coupling structure is moved by the closing element prior to expansion of the prosthetic stent segments.

92. The luminal prosthesis delivery system of claim 90, wherein the closing element is actively controlled.

93. The luminal prosthesis delivery system of claim 92, wherein the closing element comprises an inflatable member.

94. The luminal prosthesis delivery system of claim 90, wherein the closing element is activated via energy.

95. The luminal prosthesis delivery system of claim 94, wherein the closing element comprises a heating element.

96. The luminal prosthesis delivery system of claim 82, wherein the coupling structure comprises an adhesive or polymer disposed on the prosthetic stent segments, the adhesive or polymer becoming at least partially liquefied when heated.

97. The luminal prosthesis delivery system of claim 82, further comprising a decoupling element near the distal end of the delivery catheter, wherein engaging the prosthetic stent segments with the decoupling element uncouples the coupling structure between adjacent prosthetic stent segments.

98. The luminal prosthesis delivery system of claim 97, wherein the decoupling element comprises a balloon.

99. The luminal prosthesis delivery system of claim 82, wherein the coupling structure comprises a coating layer extending over an outer surface of the prosthetic stent segments.

100. The luminal prosthesis delivery system of claim 99, wherein the coating layer is a polymer.

101. The luminal prosthesis delivery system of claim 99, wherein the coating layer is biodegradable.

102. The luminal prosthesis delivery system of claim 99, wherein the coating layer is polylactic acid.

103. The luminal prosthesis delivery system of claim 99, wherein the coating layer is perforated between the adjacent stent segments.

104. The luminal prosthesis delivery system of claim 99, wherein the coating layer is breakable.

105. The luminal prosthesis delivery system of claim 99, wherein the coating layer carries a therapeutic agent.

106. The luminal prosthesis delivery system of claim 105, wherein the therapeutic agent comprises an anti-restenosis agent.

107. The luminal prosthesis delivery system of claim 82, further comprising a sheath axially positionable to cover at least a portion of the plurality of prosthetic stent segments.

108. The luminal prosthesis delivery system of claim 107, wherein the sheath is retractable to expose the first group of prosthetic stent segments while covering the second group of prosthetic stent segments.

109. The luminal prosthesis delivery system of claim 108, wherein the coupling structures between adjacent prosthetic stent segments in the first group are moved from an uncoupled position to a coupled position by retraction of the sheath.

110. The luminal prosthesis delivery system of claim 108, further comprising a decoupling element near a distal end of the sheath adapted to engage one or more of the coupling structures to decouple the prosthetic stent segments from each other.