Not Applicable
Not Applicable
1. Field of the Invention
In some embodiments this invention relates to implantable medical devices, their manufacture, and methods of use. Some embodiments are directed to delivery systems, such as catheter systems of all types, which are utilized in the delivery of such devices.
2. Description of the Related Art
Balloon catheters are employed in a variety of medical procedures. One such procedure is angioplasty which is a well known medical practice used in the treatment of diseased arteries in the vasculature of a patient. Using angioplasty procedures, alone, however, involves a risk of restenosis of the artery, which may necessitate another angioplasty procedure, a surgical bypass procedure, or some method of repairing or strengthening the area. Therefore, it has become more common practice to use a catheter-delivered stent to prevent restenosis and to reinforce and strengthen weakened vessel walls.
A stent is a medical device introduced to a body lumen and is well known in the art. Stents, grafts, stent-grafts, vena cava filters, expandable frameworks, and similar implantable medical devices, collectively referred to hereinafter as stents, are radially expandable endoprostheses which are typically intravascular implants capable of being implanted transluminally and enlarged radially after being introduced percutaneously. Typically, a stent is implanted in a blood vessel at the site of a stenosis or aneurysm endoluminally, i.e. by so-called “minimally invasive techniques” in which the stent in a radially reduced configuration, optionally restrained in a radially compressed configuration by a sheath and/or catheter, is delivered by a stent delivery system or “introducer” to the site where it is required. The introducer may enter the body from an access location outside the body, such as through the patient's skin, or by a “cut down” technique in which the entry blood vessel is exposed by minor surgical means.
After being introduced percutaneously, stents can be expanded by an internal radial force, such as when mounted on an inflatable balloon. Stents can also be self-expanding or a combination of self-expanding and balloon expandable (hybrid expandable). Stents may be implanted to prevent restenosis following angioplasty in the vascular system. Stents may be expanded and implanted in a variety of body lumens or vessels such as within the vascular system, urinary tracts, bile ducts, fallopian tubes, coronary vessels, secondary vessels, etc.
A number of complications arise when stenoses form at vessel bifurcation sites. A bifurcation site is an area of the vasculature or other portion of the body where a first (or parent) vessel is bifurcated into two or more branch vessels. Where a stenotic lesion or lesions form at such a bifurcation, the lesion(s) can affect only one of the vessels (i.e., either of the branch vessels of the parent vessel) two of the vessels, or all three vessels. One complication involves irregular folding of the balloon or balloon portion which pushes against and moves that portion of the stent which expands into the vessel bifurcation. While auxiliary portions of a delivery system have been successful in expanding portions of stents into a side branch vessel, there remains a need for devices that are particularly suitable for expanding stents at a bifurcation to achieve an ideal expanded configuration.
The art referred to and/or described above is not intended to constitute an admission that any patent, publication or other information referred to herein is “prior art” with respect to this invention
All US patents and applications and all other published documents mentioned anywhere in this application are incorporated herein by reference in their entirety.
Without limiting the scope of the invention a brief summary of some of the claimed embodiments of the invention is set forth below. Additional details of the summarized embodiments of the invention and/or additional embodiments of the invention may be found in the Detailed Description of the Invention below.
This invention contemplates a number of embodiments where any one, any combination of some, or all of the embodiments can be incorporated into a stent and/or a stent delivery system and/or a method of use. The present invention relates to novel folding arrangement for inflation balloons. The inflation balloons are folded in a systematic pattern which aids in the proper deployment of the side branch assembly of the stent. In particular, the improved folding arrangement aids in the deployment of the extending members relative to the bifurcated vessel wall. These and other aspects of the invention are set forth below.
At least one embodiment of the invention is directed to a balloon catheter comprising a balloon inflation system. The balloon inflation system has a side branch balloon structure capable of at least partially expanding a side branch structure of a bifurcated stent. When in an un-inflated configuration, the side branch balloon structure is folded in a pattern which permits orderly unfolding when the side branch is inflated. Contemplated embodiments include a main branch balloon structure capable of inflating a main tubular body of a bifurcated stent which is either in or not in fluid communication with the side branch balloon structure.
At least one embodiment of the invention is directed to a side branch balloon structure comprising a radial end, a luminal end, and a side portion extending between the radial and luminal ends. When in the inflated configuration, the radial end is further away from the main branch central axis than the luminal end, and when in the un-inflated configuration the radial and luminal ends are substantially adjacent to each other. When in the un-inflated configuration, the side branch balloon structure can be folded such that: at least some of the side portion lies flush against and over the radial end, at least some of the side portion is further folded into pleats, and/or at least some of the side portion is further folded into overlapping folds. The side portion can also be folded such that: it is folded into three or more segments with overlapping regions between the folded segments, at least one segment lies above one overlapping region and beneath one overlapping region, every folded segment lies above one overlapping region and beneath one overlapping region, at least some of the overlapping folds are of different sizes, at least some of the pleats are of different sizes, and/or the pattern is generally uniform about a side branch axis.
At least one embodiment of the invention is directed to a balloon catheter further comprising a catheter shaft disposed about which is a bifurcated stent. The bifurcated stent has a main tubular body and a side branch structure having an iris and a crown configuration. When in the crown configuration at least a portion of the side branch assembly defines a fluid lumen in fluid communication with main tubular body and extends away from the main tubular body at an oblique angle. When in the iris configuration at least a portion of the side branch assembly is positioned adjacent to the orderly folded side branch balloon structure. The side branch assembly can also comprise one or more petals which when crowned define at least a portion of the second fluid lumen. The folded pattern results in the positioning of smooth portions of the side branch balloon structure against the petals. These smooth portions can be without folds and can cause a portion of the side branch balloon structure to inflate in a sweeping rotational motion. In addition, the pattern can allow for at least a portion of the side branch balloon structure to inflate by first primarily expanding in a circumferential direction away from a center of the side branch balloon structure and later primarily expanding in a radial direction.
At least one embodiment of the invention is directed to a method of folding a side branch balloon structure comprising the steps of: forming a cup by folding a radial end of the a side branch balloon structure into a luminal end of the side branch balloon structure and forming a discus by smoothly folding down the most radial portion of the cup against the radial end of the side branch balloon structure. The method can further including the steps of: inflating the side branch balloon, deflating the side branch balloon, and crimping an unexpanded side branch assembly of an unexpanded bifurcated stent over the folded side branch balloon structure.
The invention is best understood from the following detailed description when read in connection with accompanying drawings, in which:
The invention will next be illustrated with reference to the figures wherein the same numbers indicate similar elements in all figures. Such figures are intended to be illustrative rather than limiting and are included herewith to facilitate the explanation of the apparatus of the present invention.
For the purposes of this disclosure, like reference numerals in the figures shall refer to like features unless otherwise indicated.
Depicted in the figures are various aspects of the invention. Elements depicted in one figure may be combined with, or substituted for, elements depicted in another figure as desired.
Embodiments of the invention are directed to folding arrangements of both multiple lumen type and single lumen type balloon catheters. Referring now to
Some examples of single balloon type balloon catheters are discussed in published US Patent Publication No. US 2004/0138737 A1 the entire disclosure of which is incorporated herein by reference in its entirety. In a single balloon type balloon catheter, integrated into the material of the main catheter balloon is a blister of bulge which defines the side balloon structure (5). As the main catheter balloon is inflated, its side balloon structure (5) inflates as well.
Referring again to
When the stent (1) is in the expanded state, the side branch assembly or side branch (30) forms a bifurcating side branch which defines a secondary fluid lumen (34) in fluid communication with the primary fluid lumen (14). The side branch assembly extends about a side branch axis (46). This side branch is capable of extending in a radial direction (31) out of the parent vessel and into the branch vessel. In at least one embodiment, the side branch assembly (30) comprises one or more petals (32). For purposes of this application the definition of the term “petal” is one or more side branch members capable of twisting, bending, pivoting or otherwise opening to define the second fluid lumen (34) by opening away from the tubular shape defined by the generally tubular structure of the outer surface of the first stent body (10). It will be appreciated by persons of ordinary skill in the art that side branch assemblies can also comprises non-petal structures. As a result, all embodiments in this application which describe petals will be understood to contemplate non-petal type side branch assemblies as well.
The petals (32) can be arranged in an iris configuration when the stent (1) is unexpanded and in a crown configuration when the stent (1) is expanded. For purposes of this application the definition of the term “iris” is when one or more petals (32) are generally lying along the tubular shape defined by the generally tubular structure of the outer surface of the first stent body (10) and are covering at least a portion of a side branch opening (18) in the main stent body (10). For purposes of this application the definition of the term “crown” is when as at least one petal (32) are positioned at an oblique angle radially displaced from the tubular shape defined by the generally tubular structure of the outer surface of the first stent body (10). For the purposes of this application, the definition of the term “oblique” is an angle of greater than zero degrees, such as an angle of between about 1 and about 180 degrees. An oblique angle explicitly includes angles of both exactly and about 90 degrees. The petals (32) are pushed from the iris configuration into the crown configuration at least in part by pressure applied to the inner surface of the petals (32) by the inflation of the a side balloon structure (5).
In at least one embodiment of the invention, the side balloon structure (5) when in the unexpanded state is configured according to an organized arrangement. Referring now to
As illustrated in
In at least one embodiment the cup arrangement is formed by the application of a luminally directed (35) force focused towards the center of the radial end (60) of the side balloon structure (5). This focused force cooperates with a side directed force that pushes that portion of the upper end of the balloon material internal to the inner side of the lower ends of the side lengths (58a′) to be flush with the inner side of the lower ends of the side lengths (58a′). The side balloon structure (5) can folded while, before, or after the main stent body inflating balloon or balloon portion is inflated or collapsed.
Referring now to
In at least one embodiment illustrated in
In at least one embodiment illustrated in
Referring now to
The various flush and even folding arrangements impart a number of advantages to the inflation process of the side balloon structure (5). One advantage is that the folding arrangement allows for control over the sequence of the inflation of particular portions of the side balloon structure allowing forces to be applied in a desired sequence. Another advantage is that they allow for the smooth and even expansion of the outer surface of the radial end (60b) as it moves radially (31) away from the luminal end (59). Also, the organized unfolding that the side balloon undergoes has a predictable sweeping motion which is cooperative with the crowning motion of the petals. This predictable sweeping motion reduces or prevents shear forces which can be caused by erratic motion that accompanies the inflation induced smoothing out of erratically shaped fold lines and erratically positioned portions of the side balloon structure (5). The sweeping motion with which the organized folds and pleats unfold when expanded also reduces wasted inflation energy that would otherwise accompany untangling and untwisting erratically positioned portions of the side balloon structure (5). The organized folding designs are also repeatable and can be easily integrated into industrial production lines. In addition, the organized structures reduce the likelihood of unwanted volume producing voids occupying the side branch structure (5) reducing its overall profile. Similarly, the flush and even folding arrangements when inflated allow for an increase in side balloon structure (5) volume at a uniform or predictable rate volume which reduces rapid fluctuations in the velocity of the balloon inflation which would otherwise accompany the inflation of dissimilarly folded portions.
The organized arrangement also allows for application of precise pushing force to be applied by the outer surface of the radial end (60b) against the petals. This precise pushing force increases inflation efficiency by assuring that majority of the volumetric expansion can be harnessed to crown the side branch assembly.
In
As illustrated in
Because the folding arrangement, limits the allowed initial motions to the side lengths (58) in an outwardly directed arced path there is a greatly reduced the amount of friction, rubbing or chaffing between the petal and the unfolding side balloon structure (5). In addition, because the petals (32) begin to bend outward (and away from majority of the mass of the side branch structure(5)) at the very beginning of the inflation process, the likelihood of an erratic motion by a portion of the balloon deforming, distorting, or otherwise improperly extending the side branch assembly becomes reduced. Lastly because the initial inflation process moves the petals, the petals develop outwardly directed momentum which reduces the overall energy needed to extend the petals (32).
Referring now to
Referring now to
Referring now to
Embodiments contemplated by this invention include catheters in which the main catheter balloon (3) and the side balloon structure (5) are linked to different fluid sources which allows them to undergo independent inflation and deflation. Similarly two or more inflation lumens can be positioned at locations about the side balloon structure (5). These inflation lumens need not only be distal to or proximal to the side balloon structure and can be positioned above, below, or at any position around the side balloon structure (5). Depending on the desired sequences of inflation, the catheter may be configured so that each inflation lumen can be independently filled. Alternatively the inflation lumens may be configured to be in common fluidic communication with one or more of the other inflation lumens. In addition one or more inflation lumens may be independent to provide for the withdrawal of fluid from the side balloon structure (5) or may utilize valves to only allow fluid to pass once a desired pressure level is present within the side balloon structure (5) and/or within the inflation lumen.
Coordination of the order of inflation, inflation pressure, fluid flux, and fluid flow directions can be combined with the other inflation embodiments disclosed in this application to facilitate the efficient and successful inflation of the side balloon structure (5). In at least one embodiment, at least one of one or more fluid lumens are positioned directly against or immediately adjacent to one or more balloon portions including but not limited to: a lip, a folded segment, a pleat, a radial end, a luminal end, a side length, a inner side of a side length, an outer side of a side length, an upper end of a side of a side length, a lower end of a side length, or any combination thereof to facilitate its displacement prior to the displacement by inflation fluid of another second portion of the side balloon structure (5). Sequential displacement can be accomplished by the sequential flow of fluid through a number of specifically positioned lumens against specific side balloon structure portions. Such coordinated inflation can cause Or cooperatively facilitate rotationally directed movement and momentum within the inflating side balloon structure (5).
In some embodiments the stent, its delivery system, or other portion of an assembly may include one or more areas, bands, coatings, members, etc. that are detectable by imaging modalities such as X-Ray, MRI, ultrasound, etc. In some embodiments at least a portion of the stent and/or adjacent assembly is at least partially radiopaque.
In some embodiments at least a portion of the stent is configured to include one or more mechanisms for the delivery of a therapeutic agent. Often the agent will be in the form of a coating or other layer (or layers) of material placed on a surface region of the stent, which is adapted to be released at the site of the stent's implantation or areas adjacent thereto.
The therapeutic agent can be at least one or various types of therapeutic agents including but not limited to: at least one restenosis inhibiting agent that comprises drug, polymer and bio-engineered materials or any combination thereof. In addition, the coating can be a therapeutic agent such as at least one drug, or at least one other pharmaceutical product such as non-genetic agents, genetic agents, cellular material, etc. Some examples of suitable non-genetic therapeutic agents include but are not limited to: at least one anti-thrombogenic agents such as heparin, hepatin derivatives, vasculai cell growth promoters, growth factor inhibitors, Paclitaxel, etc. Where an agent includes a genetic therapeutic agent, such a genetic agent may include but is not limited to: DNA, RNA and their respective derivatives and/or components; hedgehog proteins, etc. Where a therapeutic agent includes cellular material, the cellular material may include but is not limited to: cells of human origin and/or non-human origin as well as their respective components and/or derivatives thereof. Where the therapeutic agent includes a polymer agent, the polymer agent may be a polystyrene-polyisobutylene-polystyrene triblock copolymer (SIBS), polyethylene oxide, silicone rubber and/or any other suitable substrate. It will be appreciated that other types of coating substances, well known to those skilled in the art, can be applied to the stent (1) as well.
This completes the description of the preferred and alternate embodiments of the invention. The above disclosure is intended to be illustrative and not exhaustive. This description will suggest many variations and alternatives to one of ordinary skill in this art. The various elements shown in the individual figures and described above may be combined, substituted, or modified for combination as desired. All these alternatives and variations are intended to be included within the scope of the claims where the term “comprising” means “including, but not limited to”.
Further, the particular features presented in the dependent claims can be combined with each other in other manners within the scope of the invention such that the invention should be recognized as also specifically directed to other embodiments having any other possible combination of the features of the dependent claims. For instance, for purposes of claim publication, any dependent claim which follows should be taken as alternatively written in a multiple dependent form from all prior claims which possess all antecedents referenced in such dependent claim if such multiple dependent format is an accepted format within the jurisdiction (e.g. each claim depending directly from claim 1 should be alternatively taken as depending from all previous claims). In jurisdictions where multiple dependent claim formats are restricted, the following dependent claims should each be also taken as alternatively written in each singly dependent claim format which creates a dependency from a prior antecedent-possessing claim other than the specific claim listed in such dependent claims below.
Number | Name | Date | Kind |
---|---|---|---|
3643268 | Stamberger | Feb 1972 | A |
4309994 | Grunwald | Jan 1982 | A |
4769005 | Ginsburg et al. | Sep 1988 | A |
4774949 | Fogarty | Oct 1988 | A |
4896670 | Crittenden | Jan 1990 | A |
4905667 | Foerster et al. | Mar 1990 | A |
4906244 | Pinchuk et al. | Mar 1990 | A |
4935190 | Tennerstedt | Jun 1990 | A |
4994071 | MacGregor | Feb 1991 | A |
5037392 | Hillstead | Aug 1991 | A |
5053007 | Euteneuer | Oct 1991 | A |
5087246 | Smith | Feb 1992 | A |
5147302 | Euteneuer et al. | Sep 1992 | A |
5163989 | Campbell et al. | Nov 1992 | A |
5209799 | Vigil | May 1993 | A |
5226887 | Farr et al. | Jul 1993 | A |
5234727 | Hoberman | Aug 1993 | A |
5306246 | Sahatjian et al. | Apr 1994 | A |
5318587 | Davey | Jun 1994 | A |
5342307 | Euteneuer et al. | Aug 1994 | A |
5342387 | Summers | Aug 1994 | A |
5350361 | Tsukashima et al. | Sep 1994 | A |
5387235 | Chuter | Feb 1995 | A |
5456666 | Campbell et al. | Oct 1995 | A |
5456712 | Maginot | Oct 1995 | A |
5458572 | Campbell et al. | Oct 1995 | A |
5476471 | Shifrin et al. | Dec 1995 | A |
5478319 | Campbell et al. | Dec 1995 | A |
5487730 | Marcadis et al. | Jan 1996 | A |
5591228 | Edoga | Jan 1997 | A |
5607444 | Lam | Mar 1997 | A |
5609605 | Marshall et al. | Mar 1997 | A |
5609627 | Goicoechea et al. | Mar 1997 | A |
5613980 | Chauhan | Mar 1997 | A |
5617878 | Taheri | Apr 1997 | A |
5632762 | Myler | May 1997 | A |
5632763 | Glastra | May 1997 | A |
5632772 | Alcime et al. | May 1997 | A |
5636641 | Fariabi | Jun 1997 | A |
5669924 | Shaknovich | Sep 1997 | A |
5669932 | Fischell et al. | Sep 1997 | A |
5676697 | McDonald | Oct 1997 | A |
5683450 | Goicoechea et al. | Nov 1997 | A |
5697971 | Fischell et al. | Dec 1997 | A |
5707348 | Krogh | Jan 1998 | A |
5709713 | Evans et al. | Jan 1998 | A |
5718684 | Gupta | Feb 1998 | A |
5720735 | Dorros | Feb 1998 | A |
5746745 | Abele et al. | May 1998 | A |
5749825 | Fischell et al. | May 1998 | A |
5749890 | Shaknovich | May 1998 | A |
5755734 | Richter et al. | May 1998 | A |
5755735 | Richter et al. | May 1998 | A |
5755771 | Penn et al. | May 1998 | A |
5755773 | Evans et al. | May 1998 | A |
5755778 | Kleshinski | May 1998 | A |
5782906 | Marshall et al. | Jul 1998 | A |
5824036 | Lauterjung | Oct 1998 | A |
5824040 | Cox et al. | Oct 1998 | A |
5827320 | Richter et al. | Oct 1998 | A |
5833657 | Reinhardt et al. | Nov 1998 | A |
5851464 | Davila et al. | Dec 1998 | A |
5868777 | Lam | Feb 1999 | A |
5882334 | Sepetka et al. | Mar 1999 | A |
5893887 | Jayaraman | Apr 1999 | A |
5899842 | Di Pilla | May 1999 | A |
5961548 | Shmulewitz | Oct 1999 | A |
5972017 | Berg et al. | Oct 1999 | A |
6013054 | Jiun Yan | Jan 2000 | A |
6013055 | Bampos et al. | Jan 2000 | A |
6017324 | Tu et al. | Jan 2000 | A |
6017363 | Hojeibane | Jan 2000 | A |
6030414 | Taheri | Feb 2000 | A |
6033380 | Butaric et al. | Mar 2000 | A |
6033434 | Borghi | Mar 2000 | A |
6033435 | Penn et al. | Mar 2000 | A |
6056775 | Borghi et al. | May 2000 | A |
6059824 | Taheri | May 2000 | A |
6068655 | Seguin et al. | May 2000 | A |
6071285 | Lashinski et al. | Jun 2000 | A |
6086611 | Duffy et al. | Jul 2000 | A |
6093203 | Uflacker | Jul 2000 | A |
6096073 | Webster et al. | Aug 2000 | A |
6099497 | Adams et al. | Aug 2000 | A |
6113579 | Eidenschink et al. | Sep 2000 | A |
6117117 | Mauch | Sep 2000 | A |
6117156 | Richter et al. | Sep 2000 | A |
6126652 | McLeod et al. | Oct 2000 | A |
6129738 | Lashinski et al. | Oct 2000 | A |
6135982 | Campbell | Oct 2000 | A |
6142973 | Carleton et al. | Nov 2000 | A |
6143002 | Vietmeier | Nov 2000 | A |
6159238 | Killion et al. | Dec 2000 | A |
6165195 | Wilson et al. | Dec 2000 | A |
6168621 | Vrba | Jan 2001 | B1 |
6183509 | Dibie | Feb 2001 | B1 |
6203568 | Lombardi et al. | Mar 2001 | B1 |
6210380 | Mauch | Apr 2001 | B1 |
6210429 | Vardi et al. | Apr 2001 | B1 |
6210433 | Larre | Apr 2001 | B1 |
6254593 | Wilson | Jul 2001 | B1 |
6258115 | Dubrul | Jul 2001 | B1 |
6258116 | Hojeibane | Jul 2001 | B1 |
6261305 | Marotta et al. | Jul 2001 | B1 |
6261316 | Shaolian et al. | Jul 2001 | B1 |
6264662 | Lauterjung | Jul 2001 | B1 |
6264686 | Rieu et al. | Jul 2001 | B1 |
6286866 | Satge et al. | Sep 2001 | B1 |
6290673 | Shanley | Sep 2001 | B1 |
6293968 | Taheri | Sep 2001 | B1 |
6325826 | Vardi et al. | Dec 2001 | B1 |
6334864 | Amplatz et al. | Jan 2002 | B1 |
6346089 | Dibie | Feb 2002 | B1 |
6355060 | Lenker et al. | Mar 2002 | B1 |
6361544 | Wilson et al. | Mar 2002 | B1 |
6361555 | Wilson | Mar 2002 | B1 |
6383213 | Wilson et al. | May 2002 | B2 |
6395018 | Castaneda | May 2002 | B1 |
6436104 | Hojeibane | Aug 2002 | B2 |
6436134 | Richter et al. | Aug 2002 | B2 |
6508836 | Wilson et al. | Jan 2003 | B2 |
6517558 | Gittings et al. | Feb 2003 | B2 |
6520988 | Colombo et al. | Feb 2003 | B1 |
6540779 | Richter et al. | Apr 2003 | B2 |
6547709 | Dennis | Apr 2003 | B1 |
6579309 | Loos et al. | Jun 2003 | B1 |
6579312 | Wilson et al. | Jun 2003 | B2 |
6582394 | Reiss et al. | Jun 2003 | B1 |
6596020 | Vardi et al. | Jul 2003 | B2 |
6599316 | Vardi et al. | Jul 2003 | B2 |
6645242 | Quinn | Nov 2003 | B1 |
6689156 | Davidson et al. | Feb 2004 | B1 |
6692483 | Vardi et al. | Feb 2004 | B2 |
6695877 | Brucker et al. | Feb 2004 | B2 |
6706062 | Vardi et al. | Mar 2004 | B2 |
6749628 | Callol et al. | Jun 2004 | B1 |
6776793 | Brown et al. | Aug 2004 | B2 |
6811566 | Penn et al. | Nov 2004 | B1 |
6835203 | Vardi et al. | Dec 2004 | B1 |
6858038 | Heuser | Feb 2005 | B2 |
6884258 | Vardi et al. | Apr 2005 | B2 |
6896699 | Wilson et al. | May 2005 | B2 |
6932837 | Amplatz et al. | Aug 2005 | B2 |
6946092 | Berolino et al. | Sep 2005 | B1 |
6955687 | Richter et al. | Oct 2005 | B2 |
6955688 | Wilson et al. | Oct 2005 | B2 |
6962602 | Vardi et al. | Nov 2005 | B2 |
7018400 | Lashinski et al. | Mar 2006 | B2 |
7056323 | Mareiro et al. | Jun 2006 | B2 |
7060091 | Killion et al. | Jun 2006 | B2 |
20010003161 | Vardi et al. | Jun 2001 | A1 |
20010004706 | Hojeibane | Jun 2001 | A1 |
20010004707 | Dereume et al. | Jun 2001 | A1 |
20010012927 | Mauch | Aug 2001 | A1 |
20010016766 | Vardi et al. | Aug 2001 | A1 |
20010016767 | Wilson et al. | Aug 2001 | A1 |
20010016768 | Wilson et al. | Aug 2001 | A1 |
20010025195 | Shaolian et al. | Sep 2001 | A1 |
20010027291 | Shanley | Oct 2001 | A1 |
20010027338 | Greenberg | Oct 2001 | A1 |
20010029396 | Wilson et al. | Oct 2001 | A1 |
20010037116 | Wilson et al. | Nov 2001 | A1 |
20010037138 | Wilson et al. | Nov 2001 | A1 |
20010039448 | Dibie | Nov 2001 | A1 |
20010049552 | Richter et al. | Dec 2001 | A1 |
20010056297 | Hojeibane | Dec 2001 | A1 |
20020013618 | Marotta et al. | Jan 2002 | A1 |
20020013619 | Shanley | Jan 2002 | A1 |
20020022874 | Wilson | Feb 2002 | A1 |
20020026232 | Marotta et al. | Feb 2002 | A1 |
20020035392 | Wilson | Mar 2002 | A1 |
20020042650 | Vardi et al. | Apr 2002 | A1 |
20020052648 | McGuckin, Jr. et al. | May 2002 | A1 |
20020072790 | McGuckin, Jr. et al. | Jun 2002 | A1 |
20020111675 | Wilson | Aug 2002 | A1 |
20020156516 | Vardi et al. | Oct 2002 | A1 |
20020156517 | Perouse | Oct 2002 | A1 |
20020165604 | Shanley | Nov 2002 | A1 |
20020173835 | Bourang et al. | Nov 2002 | A1 |
20020173840 | Brucker et al. | Nov 2002 | A1 |
20020183763 | Callol et al. | Dec 2002 | A1 |
20020193872 | Trout, III et al. | Dec 2002 | A1 |
20020193873 | Brucker et al. | Dec 2002 | A1 |
20030009209 | Hojeibane | Jan 2003 | A1 |
20030028233 | Vardi et al. | Feb 2003 | A1 |
20030050688 | Fischell et al. | Mar 2003 | A1 |
20030055378 | Wang et al. | Mar 2003 | A1 |
20030055483 | Gumm | Mar 2003 | A1 |
20030074047 | Richter | Apr 2003 | A1 |
20030093109 | Mauch | May 2003 | A1 |
20030097169 | Brucker | May 2003 | A1 |
20030114912 | Sequin et al. | Jun 2003 | A1 |
20030125791 | Sequin et al. | Jul 2003 | A1 |
20030125802 | Callol et al. | Jul 2003 | A1 |
20030135259 | Simso | Jul 2003 | A1 |
20030163082 | Mertens | Aug 2003 | A1 |
20030181923 | Vardi | Sep 2003 | A1 |
20030195606 | Davidson et al. | Oct 2003 | A1 |
20040006381 | Sequin et al. | Jan 2004 | A1 |
20040015227 | Vardi et al. | Jan 2004 | A1 |
20040044396 | Clerc et al. | Mar 2004 | A1 |
20040059406 | Cully et al. | Mar 2004 | A1 |
20040088007 | Eidenschink | May 2004 | A1 |
20040117003 | Ouriel et al. | Jun 2004 | A1 |
20040133268 | Davidson et al. | Jul 2004 | A1 |
20040138732 | Suhr et al. | Jul 2004 | A1 |
20040138737 | Davidson et al. | Jul 2004 | A1 |
20040148006 | Davidson et al. | Jul 2004 | A1 |
20040172121 | Eidenschink et al. | Sep 2004 | A1 |
20040186560 | Alt | Sep 2004 | A1 |
20040225345 | Fischell et al. | Nov 2004 | A1 |
20040267352 | Davidson et al. | Dec 2004 | A1 |
20050004656 | Das | Jan 2005 | A1 |
20050010278 | Vardi et al. | Jan 2005 | A1 |
20050015108 | Williams et al. | Jan 2005 | A1 |
20050015135 | Shanley | Jan 2005 | A1 |
20050060027 | Khenansho et al. | Mar 2005 | A1 |
20050096726 | Sequin et al. | May 2005 | A1 |
20050102019 | Yadin | May 2005 | A1 |
20050102021 | Osborne | May 2005 | A1 |
20050102023 | Yadin et al. | May 2005 | A1 |
20050119731 | Brucker et al. | Jun 2005 | A1 |
20050125076 | Ginn | Jun 2005 | A1 |
20050131526 | Wong | Jun 2005 | A1 |
20050149161 | Eidenschink et al. | Jul 2005 | A1 |
20050154442 | Eidenschink et al. | Jul 2005 | A1 |
20050154444 | Quadri | Jul 2005 | A1 |
20050183259 | Eidenschink et al. | Aug 2005 | A1 |
20050209673 | Shaked | Sep 2005 | A1 |
20050228483 | Kaplan et al. | Oct 2005 | A1 |
20060036315 | Yadin et al. | Feb 2006 | A1 |
20060041303 | Israel | Feb 2006 | A1 |
20060079956 | Eigler et al. | Apr 2006 | A1 |
20060173528 | Feld et al. | Aug 2006 | A1 |
20070073376 | Krolik et al. | Mar 2007 | A1 |
Number | Date | Country |
---|---|---|
2220864 | Jul 1999 | CA |
9014845 | Feb 1991 | DE |
29701758 | Mar 1997 | DE |
29701883 | May 1997 | DE |
0479730 | Oct 1991 | EP |
0751752 | Jan 1997 | EP |
0783873 | Jul 1997 | EP |
0804907 | Nov 1997 | EP |
0479557 | Jul 1998 | EP |
0876805 | Nov 1998 | EP |
0880949 | Dec 1998 | EP |
0891751 | Jan 1999 | EP |
0895759 | Feb 1999 | EP |
0904745 | Mar 1999 | EP |
0937442 | Aug 1999 | EP |
0347023 | Dec 1999 | EP |
1031328 | Aug 2000 | EP |
1031329 | Aug 2000 | EP |
0883384 | Dec 2000 | EP |
0862392 | Aug 2001 | EP |
0808140 | Dec 2001 | EP |
0884028 | Feb 2002 | EP |
1190685 | Mar 2002 | EP |
0897700 | Jul 2002 | EP |
0684022 | Feb 2004 | EP |
1157674 | Jul 2005 | EP |
1031330 | Nov 2005 | EP |
1070513 | Jun 2006 | EP |
2678508 | Jan 1993 | FR |
2740346 | Oct 1995 | FR |
2756173 | Nov 1996 | FR |
2337002 | May 1998 | GB |
8806026 | Aug 1988 | WO |
9521592 | Aug 1995 | WO |
9629955 | Oct 1996 | WO |
9634580 | Nov 1996 | WO |
9641592 | Dec 1996 | WO |
9707752 | Mar 1997 | WO |
9715346 | May 1997 | WO |
9716217 | May 1997 | WO |
9726936 | Jul 1997 | WO |
9741803 | Nov 1997 | WO |
9745073 | Dec 1997 | WO |
9746174 | Dec 1997 | WO |
9819628 | May 1998 | WO |
9836709 | Aug 1998 | WO |
9837833 | Sep 1998 | WO |
9847447 | Oct 1998 | WO |
9848879 | Nov 1998 | WO |
9903426 | Jan 1999 | WO |
9904726 | Feb 1999 | WO |
9915103 | Apr 1999 | WO |
9915109 | Apr 1999 | WO |
9924104 | May 1999 | WO |
9934749 | Jul 1999 | WO |
9936002 | Jul 1999 | WO |
9936015 | Jul 1999 | WO |
9944539 | Sep 1999 | WO |
9956661 | Nov 1999 | WO |
9965419 | Dec 1999 | WO |
0007523 | Feb 2000 | WO |
0010489 | Mar 2000 | WO |
0016719 | Mar 2000 | WO |
0027307 | May 2000 | WO |
0027463 | May 2000 | WO |
0028922 | May 2000 | WO |
0145594 | Jun 2000 | WO |
0044307 | Aug 2000 | WO |
0044309 | Aug 2000 | WO |
0047134 | Aug 2000 | WO |
0048531 | Aug 2000 | WO |
0049951 | Aug 2000 | WO |
0051523 | Sep 2000 | WO |
0057813 | Oct 2000 | WO |
0067673 | Nov 2000 | WO |
0071054 | Nov 2000 | WO |
0071055 | Nov 2000 | WO |
0074595 | Dec 2000 | WO |
0121095 | Mar 2001 | WO |
0121109 | Mar 2001 | WO |
0121244 | Mar 2001 | WO |
0135715 | May 2001 | WO |
0135863 | May 2001 | WO |
0139697 | Jun 2001 | WO |
0139699 | Jun 2001 | WO |
0141677 | Jun 2001 | WO |
0143665 | Jun 2001 | WO |
0143809 | Jun 2001 | WO |
0145785 | Jun 2001 | WO |
0149342 | Jul 2001 | WO |
0154621 | Aug 2001 | WO |
0154622 | Aug 2001 | WO |
0158385 | Aug 2001 | WO |
0160284 | Aug 2001 | WO |
0170294 | Sep 2001 | WO |
0170299 | Sep 2001 | WO |
0174273 | Oct 2001 | WO |
0189409 | Nov 2001 | WO |
0200138 | Jan 2002 | WO |
02053066 | Jul 2002 | WO |
02068012 | Sep 2002 | WO |
03007842 | Jan 2003 | WO |
03055414 | Jul 2003 | WO |
03063924 | Aug 2003 | WO |
2004026174 | Apr 2004 | WO |
2004026180 | Apr 2004 | WO |
2005009295 | Feb 2005 | WO |
2005014077 | Feb 2005 | WO |
2006028925 | Mar 2006 | WO |
WO 2006127127 | Nov 2006 | WO |
Entry |
---|
Chevalier, M.D., Bernard, “Placement of Coronary Stents in Bifurcation Lesions by the “Culotte” Technique,” The American Journal of Cardiology, vol. 82, pp. 943-949 (Oct. 15, 1998). |
Nakamura M.D., Shigeru, “Techniques for Palmaz-Schatz Stent Deployment in Lesions with a Large Side Branch,” Catheterization and Cardiovascular Diagnosis, vol. 34, pp. 353-361 (1995). |
Caputo, Ronald P., “Stent Jail: A Minimum-Security Prison,” The American Journal of Cardiology, vol. 77, pp. 1226-1230 (Jun. 1, 1996). |
Colombo, M.D., Antonio, ““Kissing” Stent for Bifurcational Coronary Lesion,” Catheterization and Cardiovascular Diagnosis, vol. 30, pp. 327-330 (Dec. 1993). |
Carrie, M.D., Didier, ““T”-Shaped Stent Placement: A Technique for the Treatment of Dissected Bifurcation Lesions,” Catheterization and Cardiovascular Diagnosis, vol. 37, pp. 311-313 (Mar. 1996). |
Katoh, M.D., Osamu, “New Double Wire Technique to Stent Ostial Lesions,” Catheterization and Cardiovascular Diagnosis, vol. 40, pp. 400-402 (Apr. 1997). |
Lewis, M.D., Bruce E., “Acute procedural results in the treatment of 30 coronary artery bifurcation lesions with a double-wire atherectomy technique for side-branch protection,” American Heart Journal, vol. 127:6, pp. 1600-1607 (Jun. 1994). |
Yamashita, M.D.,PhD., Takehiro, “Bifurcation Lesions: Two Stents Versus One Stent—Immediate and Follow-up Results,” Journal of the American College of Cardiology, vol. 35:5, pp. 1145-1151 (Apr. 2000). |
Satler, M.D., Lowell F., “Bifurcation Disease: to Treat or Not to Treat,” Catheterization and Cardiovascular Interventions, vol. 50, pp. 411-412 (2000). |
U.S. Appl. No. 09/663,111, filed Sep. 15, 2000, Davidson et al. |
U.S. Appl. No. 09/614,472, filed Jul. 11, 2000, Davidson et al. |
U.S. Appl. No. 09/235,996, filed Jun. 4, 1999, Vardi et al. |
Number | Date | Country | |
---|---|---|---|
20080243221 A1 | Oct 2008 | US |