U.S. application Ser. No. 11/623,022, filed Jan. 12, 2007, entitled “DUAL CONCENTRIC GUIDEWIRE AND METHODS OF BIFURCATED GRAFT DEPLOYMENT,” U.S. application Ser. No. 12/101,863, filed Apr. 11, 2008, entitled “BIFURCATED GRAFT DEPLOYMENT SYSTEMS AND METHODS,” U.S. application Ser. No. 12/496,446, filed Jul. 1, 2009, entitled “CATHETER SYSTEM AND METHODS OF USING SAME,” U.S. application Ser. No. 12/769,506, filed Apr. 28, 2010, entitled “APPARATUS AND METHOD OF PLACEMENT OF A GRAFT OR GRAFT SYSTEM,” and U.S. Pat. No. 6,077,296, entitled “ENDOLUMINAL VASCULAR PROSTHESIS,” are hereby incorporated by reference as if fully set forth herein.
The present disclosure relates to catheter systems, in particular, catheter systems for delivering a medical prosthesis.
Introducer catheters or introducer sheaths can be used for minimal invasive placement of catheters into blood vessels. Introducer catheter sheaths typically comprise tubing that is inserted into the blood vessel and a seal or valve at the proximal end of the tubing which is positioned outside of the body. The seal can provide a hemostatic seal against blood loss. Stents or other medical prostheses are typically passed through the introducer sheath into the blood vessel or body passageway. The introducer sheath thus provides continuous access for the delivery of stents or other medical prostheses, protects the inner wall of the blood vessel or body passageway against damage when the stent or other prostheses is advanced through the body passageway, and provides a hemostasis seal against blood loss.
There are situations in which the catheters require substantial maneuvering within the blood vessel. For example, placement of a stent or stent graft may require the delivery catheter to be positioned precisely axially as well as rotationally at a specific location within the blood vessel. In addition deployment of the stent may require precise operation of the delivery system within the introducer. In these situations, the operator has to carefully control both the position of the introducer and the delivery system. A need exists for a delivery system that permits a user or medical practitioner to precisely control the axial position of the stent or prosthesis during deployment.
Embodiments disclosed herein pertain to a catheter system for the insertion and positioning of diagnostic or therapeutic devices into blood vessels. The system comprises an introducer or an introducer sheath (also referred to herein as an outer sheath) and at least one delivery catheter. The introducer catheter can be introduced through a percutaneous puncture site into the blood stream. A docking mechanism can engage the proximal end of the introducer catheter assembly with a distal end portion of a delivery catheter and can prevent axial movement between the introducer catheter assembly and the delivery catheter assembly.
The catheter system can include an introducer catheter and a delivery catheter, where the introducer catheter includes an outer sheath and a seal that has an adjustable hemostasis valve connected to the proximal portion of the outer sheath. The introducer catheter and the delivery catheter can be configured such that the delivery catheter can removably engage with the introducer catheter such that, when the delivery catheter is engaged with the introducer catheter, the delivery catheter can be axially fixed to the introducer catheter so as to prevent substantial axial movement between the introducer catheter and the delivery catheter and to enable the catheters to be manipulated in an axial direction as a single unit.
Alternatively, the delivery catheter and introducer catheter can be configured such that, when the delivery catheter is engaged with the introducer catheter, an inner core of the delivery catheter can be rotated relative to the introducer catheter and the introducer sheath (also referred to herein as an outer sheath). Alternatively, the delivery catheter can be configured such that the inner core thereof can be locked or substantially prevented from rotational movement relative to the outer sheath of the introducer catheter and/or relative to the introducer catheter. Also disclosed is a method of placement of a stent or medical prosthesis into a blood vessel, wherein the stent or medical prosthesis is passed through an introducer sheath and the proximal end of the introducer catheter physically engages with or is removably docked with a distal end portion of the delivery catheter to prevent substantial axial motion between the introducer sheath and the delivery catheter.
Some endoprostheses, including stents, grafts, stent grafts, and dissection treatment devices, (all such endoprostheses are collectively referred to herein as a stent or stents) may require precise placement in both axial and rotational direction. For example, stents or stent grafts with fenestrations require accurate placement of those fenestrations relative to the branch vessels. The catheter systems disclosed herein can be configured to allow for the rotation of the delivery catheter and, hence, the stent, relative to the introducer sheath. In some embodiments, the friction that can otherwise impede the rotational freedom of the delivery catheter can be further reduced by lining the inner surface of the introducer sheath and/or the tubular sheath of the deployment catheter with a low-friction coating such as polytetrafluoroethylene, silicone, hydrophobic silicone, or other lubricating substance, or by applying a hydrophilic coating to the outer surface of the inner core or restraining sheaths of the delivery catheter. The lubrication can be swabbed onto the target surface.
Thus, the introducer sheath can remain rotationally static or fixed while the delivery catheter is rotated within the introducer sheath. This can protect the delivery catheter and stent from being damaged, torqued, or stressed during the rotational manipulation of the delivery catheter and stent, and also prevent any damage or stress on the vessel wall from the rotation of the delivery catheter or stent.
Additionally, the delivery catheter can be configured to permit a user or medical practitioner to selectively control or prevent the rotational movement of the delivery catheter and stent relative to the introducer catheter, or the inner core of the delivery catheter and stent relative to the outer sheath of the delivery catheter. For example, the delivery catheter can comprise a threaded hub supported at the proximal end portion of the delivery catheter configured to selectively constrict or tighten against an outer wall of the inner core of the delivery catheter. By constricting the hub against the inner core, the inner core can be prevented or inhibited from rotating relative to the introducer catheter. By loosening the hub relative to the inner core, the rotational freedom of the inner core or delivery catheter relative to the introducer sheath can be restored.
These and other features, aspects and advantages will now be described in connection with certain embodiments, in reference to the accompanying drawings. The illustrated embodiments, however, are merely examples and are not intended to be limiting. The following are brief descriptions of the drawings.
The following detailed description is now directed to certain specific embodiments. In this description, reference is made to the figures wherein like parts are designated with like numerals throughout the description and the drawings. Described below are various embodiments of a catheter system that can comprise an introducer sheath and a docking arrangement. The catheter systems disclosed herein can be used in diagnostic or therapeutic procedures such as, but not limited to, endoluminal vascular prosthesis deployment procedures.
The catheter 20 catheter has a shaft 24 and a male docking mechanism 22. As illustrated in
The introducer 12 comprises a tubular introducer sheath 14 and a seal 16 (which, again, can be a rubber seal, an interference or close tolerance fit, an adjustable hemostasis valve, or any other suitable sealing component or feature) connected to the proximal end of the introducer sheath 14. The overall design of the sheath 14 and seal 16 may be similar to the design of commercially available introducers, or any other introducers presently known or later developed. The catheter 20 has an outside dimensional profile (crossing profile) that is sized and/or configured to pass through the introducer sheath 14. The proximal end of the catheter 20 and the proximal end of the introducer sheath 14 are configured to permanently or removably engage with each other, and to allow for the rotation of the catheter 20 within the introducer sheath 14 while substantially limiting the axial movement of the catheter 20 with respect to the introducer sheath 14.
With respect to the sizing of the introducer lumen versus the size of the outer sheath (containing the stent graft), in one configuration they are the same size and the introducer acts as a sheath, as the stent graft is pushed from its initial position within the outer sheath through to the lumen of the introducer. In a second configuration, the introducer lumen is larger than the outside diameter of the outer sheath and the two easily rotate relative to one another as needed for rotational alignment. Further, the introducer material can be softer or more flexible material than the outer sheath, so while the stent graft could be initially loaded into a strong high-strength sheath material, it could be extruded through to the lower strength more highly flexible introducer material for the short time needed to deliver the stent grafts to its treatment site. The materials that might be used to provide this feature, include any kind of soft polymer extrusion including Nylon, PEBAX, and PE.
After engagement of the catheter and introducer, the combined system is operable by a single operator. The catheter system 10 is configured so that the catheter 20 can substantially freely rotate within the introducer sheath 14, which can allow for precise rotational positioning of the catheter within the introducer. After completion of the procedure, the catheter 20 is disengaged from the introducer 12 so that the catheter 20 can be removed from the patient's body. Additionally, the introducer 12 can be repositioned for a second intervention and a second catheter can be inserted and engaged with the introducer 12 for additional procedures.
In particular,
Self-expanding stent or stents grafts are typically retained in a deployment sheath within the delivery catheter. The deployment sheath can protect the stent or stent graft and the vessel wall from damage during insertion and can retain the stent or stent graft in a collapsed low-profile configuration during delivery. The stent or stent graft can be deployed in the desired position of the blood vessel by removing the deployment sheath and allowing the stent or stent graft to radially expand against the wall of the blood vessel. To pass such a delivery catheter into the desired blood vessel, the catheter system can be configured so that the inner diameter of the introducer sheath is larger than the outer diameter of the deployment sheath. Clinicians prefer a low profile of the introducer sheath to minimize damage to the blood vessel and allowing for access into small blood vessels.
Cartridge systems have been developed, in which the stent or stent graft can be transferred from delivery sheath into the introducer sheath and the stent or stent graft can be passed through the introducer sheath to the target location. In such cartridge systems, the introducer sheath effectively acts as a deployment sheath. The transfer eliminates the need for a second sheath and minimizes the profile of the system in the blood vessel. The docking arrangement provides a secure engagement of the delivery catheter and the introducer sheath prior to transfer of the stent or stent graft into the introducer sheath. This prevents potential user errors in the transfer and further converts the delivery catheter and introducer sheath into a single-user system.
As illustrated in
As illustrated in
As illustrated in
In the configuration described the device can be rotated after it has been introduced to the introducer, but before it is deployed, further the device can be accurately position as a result of the low friction between the introducer and the outer sheath. When devices having an expanded diameter of 25 and 28 mm diameter devices are to be used, the same (one size) introducer sheath can be used for either and both devices delivery. Only when a larger 34 mm diameter device, having a larger compressed crossing profile, is to be delivered, is it necessary to use a larger introducer. The fact that the introducer and delivery catheter mechanically engage and create a single unitary structure which can be held by one hand, allows a single user to manipulate the whole system with two hands one hand holding the core stationary and the second hand manipulating the sheath retraction mechanism.
As is known in the art, delivery catheters with loaded stent grafts typically have less trackability and pushability than an introducer sheath supported by a dilator. This is due to the fact that the stent grafts alter the local stiffness of the catheters. This can lead to kinking of the delivery catheter during insertion. By placing the introducer sheath with a dilator first, a conduit for placing the stent graft is established. Kinking of the delivery system pacing through the sheath is very unlikely.
In some embodiments, a first tube 107 can be supported by the main body 106 so as to provide an orifice or access port into the main body 106. The first tube 107 can be used to flush the introducer 102 with saline or other suitable substances at any stage, such as but not limited to prior to the advancement of an endoluminal prosthesis through the introducer 102, or prior to other procedures for which an introducer may be used. The first tube 107 can support any suitable medical connector and/or valve on the distal end thereof.
The introducer sheath 110 can have an elongate portion 110a extending to any predetermined or desired length. As will be discussed in greater detail below, similar to the introducer 12 of the catheter system 10 described above, the introducer sheath 110 can be configured such that an endoluminal prosthesis that is advanced into the introducer sheath 110 can be constrained or restrained by the introducer sheath 110. In this arrangement, the inside and/or outside diameter of the introducer sheath 110 can be approximately the same as or similar to the inside and/or outside diameter of the outer sheath of a delivery catheter that is engaged with the introducer 102. The elongate portion 110a can be circular in cross-section (as illustrated), or can define any suitable cross-sectional shape such as without limitation triangular, square, hexagonal, octagonal, or polygonal.
Further, as shown most clearly in
Additionally, with reference to
As shown most clearly in
With reference to
Similarly, the hub portion 108 can define an inner annular surface 118 that can be angled so as to not be perpendicular to the axial centerline of the catheter system 100. The surface 118 of the hub portion 108 can be angled approximately 75 degrees relative to the axial centerline of the catheter system 100, or from approximately 65 degrees or less to approximately 80 degrees or more and relative to the axial centerline of the catheter system 100 in a direction that is opposite to the direction of the angle defined by the surface 116 of the main body 106. In some embodiments, as in the illustrated embodiment, the shape and angular orientation of the surface 118 of the hub portion 108 can approximately mirror the shape and angular orientation of the surface 116 of the main body 106. The surface 118 can be approximately perpendicular to the axial centerline of the catheter system 100.
An annular seal member 120 can be supported by the introducer 102 and positioned be-tween the surface 116 of the main body 106 and the surface 118 of the hub portion 108. The seal member 120 can be formed from a resilient material, such as silicone, rubber or any other suitable material. The seal member 120 can be configured such that, when the hub portion 108 is threaded onto the main body 106, the surface 118 of the hub portion 108 can be moved axially toward the surface 116 of the main body 106, thereby compressing or squeezing the seal member 120. The relative angles of the surface 116 of the main body 106 and the surface 118 of the hub portion 108 can cause the seal member 120 to be forced against an outer sheath 122 of the delivery catheter 104 or other component of the delivery catheter 104 that is engaged with the introducer 102, thereby creating an adjustable seal between the outer sheath 122 of the delivery catheter 104, which can project distally from an end portion of the delivery catheter 104, and the introducer 102. The level of seal can be adjusted by tightening or loosening the hub portion 108 of the introducer 102 relative to the main body 106 of the introducer 102. The introducer 102 can be configured to provide a seal against devices with a profile ranging from 1 Fr to 20 Fr.
Alternatively, in some embodiments, any of the seals or seal portions described herein can be an interference or close tolerance fit between adjacent components such as, the outer sheath 122 and one or more inside surfaces of the main body 106 or the hub portion 108 of the introducer 102. In some embodiments, any of the seals or seal portions described herein can be an interference or close tolerance fit between the inner core 154 and one or more inside surfaces of the main body 140 or the hub portion 142 of the catheter 104.
As shown in
As mentioned above, the inside and/or outside diameter of the outer sheath 122 of a delivery catheter 104 can be approximately the same as or similar to the inside and/or outside diameter of the introducer sheath 110. The elongate portion 122a can be circular in cross-section (as illustrated), or can define any suitable cross-sectional shape such as without limitation triangular, square, hexagonal, octagonal, or polygonal.
The outer sheath 122 can have a flared end portion 122b that can be configured to abut against a fore surface 140a of the main body 140. With reference to
Additionally, with reference to
Similar to the hub portion 108 of the introducer 102, the hub portion 142 of the delivery catheter 104 can be configured to be threadably engageable with the main body 140 of the delivery catheter 104. The main body 140 can define an inner annular surface 146 that can be angled so as to not be perpendicular to the axial centerline of the catheter system 100. The surface 146 can be angled approximately 75 degrees relative to the axial centerline of the catheter system 100, or from approximately 80 degrees or more to approximately 65 degrees or less relative to the axial centerline of the catheter system 100. The surface 146 can be approximately perpendicular to the axial centerline of the catheter system 100.
In some embodiments, a second tube 141 can be supported by the main body 140 so as to provide an orifice or access port into the main body 140. The second tube 141 can be used to flush the delivery catheter 104 with saline or other suitable substances at any stage, such as but not limited to prior to the advancement of an endoluminal prosthesis through the delivery catheter 104 and/or introducer 102, or prior to other procedures for which an delivery catheter may be used. The second tube 141 can support any suitable medical connector and/or valve on the distal end thereof.
Similarly, the hub portion 142 can define an inner annular surface 148 that can be angled so as to not be perpendicular to the axial centerline of the catheter system 100. The surface 148 of the hub portion 142 can be angled approximately 75 degrees relative to the axial centerline of the catheter system 100, or from approximately 65 degrees or less to approximately 80 degrees or more relative to the axial centerline of the catheter system 100 in a direction that is opposite to the direction of the angle defined by the surface 146 of the main body 140. The surface 148 can be approximately perpendicular to the axial centerline of the catheter system 100.
Similar to that of the introducer, in some embodiments, a seal or seal portion comprising an annular seal member 150 can be supported by the delivery catheter 104 and positioned between the surface 146 of the main body 140 and the surface 148 of the hub portion 142. The seal member 150 can be formed from a resilient material, such as silicone, rubber or any other suitable material. The seal member 150 can be configured such that, when the hub portion 142 is threaded onto the main body 140, the surface 148 of the hub portion 142 can be moved axially toward the surface 146 of the main body 140, thereby compressing or squeezing the seal member 150. The relative angles of the surface 146 of the main body 140 and the surface 148 of the hub portion 142 can cause the seal member 150 to be forced against the inner core 154 of the delivery catheter 104, thereby creating an adjustable seal between the inner core 154 the outer sheath 122 of the delivery catheter 104.
The level of seal can be adjusted by tightening or loosening the hub portion 142 of the delivery catheter 104 relative to the main body 140 of the delivery catheter 104. Additionally, the rotational freedom of inner core 154 of the delivery catheter 104 can be inhibited or prevented by tightening the seal member 150 as described above. Thus, the force exerted by the seal member 150 on the inner core 154 can be adjusted to permit the inner core 154 and/or other components to rotate relative to the main body 140 and hub portion 142 of the delivery catheter 104. As illustrated in
The inner core 154 can have a band or other marking 155 near a distal end thereof. The marking 155 can be sized, positioned, and configured to provide a visual indication to the medical practitioner as to the location of the end portion 154a of the inner core 154 and/or the location of a catheter tip 162 as the inner core 154 is being advanced into or withdrawn from the introducer 102.
In some embodiments, as illustrated most clearly in
As mentioned above, in some embodiments, as in the illustrated embodiment, the docking mechanism 112 of the introducer 102 can be configured to receive a male docking member or portion of the catheter 104. In particular, with reference to
In this configuration, the catheter 104 can be axially engaged with or locked to the introducer 102 so that a user can axially manipulate the introducer 102 and the catheter 104 simultaneously. Additionally, in some embodiments, in this configuration, as discussed above, the catheter system 100 can be configured such that at least the inner core 154 of the catheter 104 can be rotated relative to the main body 140 of the catheter 104 and the introducer 102.
In some embodiments, as shown in
Additionally, in some embodiments (not illustrated), the tabs 174 can be sized, spaced, and otherwise configured to provide axially support to multiple individual stent segments. For example, without limitation, multiple independent or tethered stent segments can be positioned within a tubular or bifurcated graft, and the stent graft can be positioned relative to the tabs 174 such that the tabs 174 are positioned between the stent segments. This arrangement can reduce the overall diameter of the outer sheath 122, the introducer sheath 110, and other components comprising the catheter system, can enhance the axial support provided by the tabs 174 to the endoluminal prosthesis, and can allow for a more uniform distribution of support forces between the tabs 174 and the endoluminal prosthesis. The tabs 174 can be sized, spaced, and otherwise configured so as to be positioned adjacent to the links, bends, loops, and/or other connectors formed in a tubular or bifurcated stent, such as the links, bends, loops, and/or other connectors comprising the embodiments of the stents disclosed in U.S. Pat. No. 6,077,296 titled ENDOLUMINAL VASCULAR PROSTHESIS, which patent is hereby incorporated by reference as if fully set forth herein.
With reference to
In some embodiments (not illustrated), the distal end portion 122c of the outer sheath 122 can be positioned near to or approximately adjacent to the proximal end portion or the flared portion 110b of the introducer sheath 110, regardless of whether the catheter 104 has a constricted portion 113. The inner diameter of the constricted portion 113 can be approximately the same as the inner diameter of the outer sheath 122 and/or the inner diameter of the introducer sheath 110.
Therefore, The outer sheath 122 of the catheter 104 and the introducer sheath 110 can be configured to provide a lumen having a generally uniform cross-sectional size through the catheter system through which the endoluminal prosthesis can be advanced. The lumen through the catheter system 100 through which the endoluminal prosthesis can be advanced can be substantially continuous, so that the endoluminal prosthesis can be advanced through the catheter system 100 without the pros-thesis being obstructed by or snagging on any components or features of the catheter system 100 as it is being advanced. The lumen can be substantially continuous but have short gaps on the order of approximately 1 mm to approximately 3 mm in the lumen such as, without limitation, adjacent to the distal end of the outer sheath 122 of the catheter 104 and/or adjacent to the proximal or flared end 110b of the introducer sheath 110. For example, in some embodiments, short gaps can be formed adjacent to the distal end of the outer sheath 122 of the catheter 104 and/or adjacent to the proximal or flared end 110b of the introducer sheath 110 as some components comprising the catheter system 100 are threadedly engaged with other components comprising the catheter system 100. Further, in some embodiments, one or more surfaces of other components comprising the catheter 104 or the introducer 102 in addition to the outer sheath 122 and the introducer sheath 110, such as without limitation the constricted portion 113 of the main body 106 of the introducer 102 as discussed above, can form portions of the lumen through the catheter system 100.
The outer sheath 122 can constrain or restrain an endoluminal prosthesis supported by the central tube 176 as described above. In this configuration, as the catheter tip 162, central core 154, and an endoluminal prosthesis (such as, but not limited to, stent 157 illustrated in
The endoluminal prosthesis or the stent 157 can be a tubular stent, a bifurcated stent, or any other desirable stent, graft, stent graft, or endoluminal prosthesis (collectively referred to herein as stent or stents), including without limitation any of the stents or grafts disclosed in U.S. patent application Ser. No. 12/101,863 referenced above and incorporated herein by reference as if fully set forth herein. Accordingly, the catheter system 100 or catheter 104 can be configured to deploy any suitable or desirable stent or stents.
Thus, in this configuration, the endoluminal prosthesis can be transferred from the outer sheath 122 to the introducer sheath 110. In this arrangement, using the introducer sheath 110 as the restraint can allow the outside diameter of the introducer sheath 110 to be reduced, which can minimize trauma to the patient's vasculature and assist in the deployment of the endoluminal prosthesis.
Many embodiments of the docking mechanism and catheter system have been described in connection with
The catheter system disclosed in
The catheter systems disclosed herein can be used for diagnostic or therapeutic procedures such as, but not limited to, endoluminal vascular prosthesis deployment procedures. It should be apparent to one skilled in the art that the catheter system embodiments disclosed herein can be used for delivering prostheses for supporting body tissue in general as well as various blood vessels and aneurysms. Examples of such blood vessels that can be treated with the catheter system embodiments disclosed herein include the aorta, aortic aneurysms such as abdominal aortic aneurysms, saphenous vein grafts, the vena cava, the renal arteries, the iliac arteries, the femoral arteries, the popliteal artery, the carotid artery, the cranial arteries, pulmonary arteries, etc. Other organs or body tissue that can be treated with some catheter system embodiments disclosed herein include the prostate, the biliary tract, the esophagus, the trachea, the fallopian tubes, the vas deferens, the ureters, the tear ducts, the salivary ducts.
The catheter systems disclosed herein can be configured for deployment of a wide range of endoluminal prostheses, including mechanically expandable stents, self-expanding stents, drug eluting stents, grafts, bifurcated and non-bifurcated stent grafts, fenestrated stent grafts, suprarenal stent extensions, stent segments, dissection treatment devices, medical prostheses deployable in any suitable region of the body, and any of the stents or prostheses disclosed in U.S. application Ser. No. 12/101,863, filed Apr. 11, 2008, U.S. application Ser. No. 12/496,446, filed Jul. 1, 2009, U.S. application Ser. No. 12/769,506, filed Apr. 28, 2010, and U.S. Pat. No. 6,077,296, which are hereby incorporated by reference as if fully set forth herein.
The stent can have an oversized graft have a mid portion that is not sutured or otherwise attached to the stent frame. In this configuration, the mid portion can be permitted to expand against an inside wall of the vessel or passageway to further improve the seal between the graft and the vessel wall. Additionally, the stent can have an oversized graft of highly collapsible, flexible material (e.g., expanded polytetrafluoroethylene) such that, when the stent is expanded, the graft can form tight folds in the seal zone to reduce cross-sectional area of leak zones between the stent and the vessel wall.
For simplicity, all such foregoing stents or prostheses are collectively referred to herein as a stent or stents unless otherwise defined. Therefore, while illustrations and the disclosure that follows may describe stents and may show deployment in a particular passageway or in a region of the body, it is contemplated that any of the embodiments disclosed herein can be used, with or without modifications within the capabilities of one of ordinary skill in the art, for deployment of any desired prosthesis in any suitable portion of the body.
Additional details regarding the features and components of such a docking arrangement and other details regarding the catheter system are disclosed in U.S. application Ser. No. 12/101,863, filed Apr. 11, 2008, entitled “BIFURCATED GRAFT DEPLOYMENT SYSTEMS AND METHODS” and U.S. application Ser. No. 12/496,446, filed Jul. 1, 2009, entitled “CATHETER SYSTEM AND METHODS OF USING SAME,” both incorporated by reference as if fully set forth herein. Any of the embodiments of the catheter systems, the delivery catheters, and the introducer catheters disclosed herein can have any of the components, features, materials, or other details of any of the embodiments of the catheters disclosed in the foregoing applications, which combinations are made part of this disclosure.
One or more stents can be loaded in, supported by, and delivered by the catheter system 100 embodiments disclosed herein. A stent or stents can be loaded into the delivery catheter assembly 104 during assembly of the delivery catheter assembly 104 or just before the surgical procedure by compressing the stent around an outer surface of an inner core member 115 of the delivery catheter assembly 104.
A removable restraint and/or an outer sheath of the introducer catheter and/or delivery catheter can hold the stent in a compressed state. In the compressed state, the stent can be held in a generally fixed axial position relative to the inner core such that axial or rotational movement of the inner core will result in axial and rotationally movement of the stent. As will be discussed, the inner core can have features, such as fins, beads, tabs, or other projections, to improve the traction or grip between the compressed stent and the inner core or inner core wire. The inner core with the stent compressed around the outer surface thereof will be advanced through a constriction element in or adjacent to the introducer catheter to compress the stent to the approximate inner diameter of the outer sheath projecting from the introducer catheter.
The inner core member 115 can have a core wire 117 forming a portion of the inner core member 115. An atraumatic distal tip 119 can be supported at a distal end portion of the core wire 117. The inner core member 115, core wire 117, and the distal tip 119 can comprise a continuous lumen therethrough, being configured to receive a guide wire therein such that the inner core member 115, the core wire 117, and the distal tip 119 can be advanced over the guide wire. The stent can be collapsed or compressed about at least a portion of the inner core wire 117 in the stent loaded condition.
As mentioned, the catheter system can be configured such that the inner core member 115 is axially slidable relative to the outer sheath 110. In this configuration, the stent can be deployed in the target region of the patient's vasculature by retracting the outer sheath 110 relative to the inner core member 115, thereby exposing the stent. In some embodiments where the outer sheath 110 provides radial constraint to the stent, exposing the stent will permit a self-expanding stent to self-expand against the vessel wall as the outer sheath 110 is being retracted.
As will be described in greater detail, some embodiments of the catheter system 100 disclosed herein are configured such that, when a user or surgeon manipulates the delivery catheter assembly 104 slowly and with mechanical advantage in a first manner, the delivery catheter can be used to slowly and controllably deploy a stent or a portion of a stent from the delivery catheter assembly 104. Some embodiments of the catheter system disclosed herein are further configured such that, when a user or surgeon manipulates the delivery catheter assembly 104 quickly by directly pulling the adjustment member in a second manner, the delivery catheter assembly 104 is used to more rapidly deploy the stent or a portion of the stent from the delivery catheter assembly 104.
The catheter systems disclosed herein can be configured to accommodate any combination of the manners of deployment described above. For example, the user or surgeon can initially manipulate the delivery catheter in the first manner to slowly deploy the stent from the delivery catheter assembly 104 and then, once the proper positioning of the partially deployed stent is confirmed, the surgeon can then manipulate the delivery catheter assembly 104 in the second manner to rapidly deploy the remainder of the stent.
With reference to
The delivery catheter assembly 104 has a main body or housing shaft 121 having a distal end portion 121a and a proximal end portion 121b. The housing shaft 121 pounds a generally tubular cross-sectional shape, and has external threads 126 along a portion of the housing shaft 121 (referred to as the threaded portion 126).
The housing shaft 121 supports a slidable handle member 128 that can be configured to slide axially along the housing shaft 121 between the distal end portion 121a of the housing shaft 121 and an rotatable adjustment member 130 supported by the housing shaft 121. As will be described, the delivery catheter assembly 104 is configured such that the handle member 128 is selectively engageable with the inner core member 115. When in the engaged configuration, movement of the handle member 128 results in simultaneous and equal movement of the inner core member 115. The delivery catheter assembly 104 can be configured such that the handle member 128 is prevented from rotating relative to the housing shaft 121 and, consequently, the introducer catheter 102 and outer sheath 110, to prevent any inadvertent rotation of the inner core member 115 when the handle member 128 is engaged with the inner core member 115.
The threaded portion 126 extends along approximately 60% of the length of the housing shaft 121. The threaded portion 126 can extend along approximately 40% to approximately 70% of the length of the housing shaft 121. The threaded portion 126 can be positioned adjacent to the proximal end portion 121b of the housing shaft 121. The length of the threaded portion 126 can be from approximately 20% to approximately 200% of the length of the stent to be deployed by the catheter. For example, if only the proximal end portion of the stent is to be deployed by rotation of the adjustment member 130, the length of the threaded portion can be approximately from 20% to approximately 50% of the length of the stent. As used throughout this disclosure, the term approximately can mean plus or minus 15% of the stated value.
Preventing the rotational movement of the handle member 128 can be achieved in any number of ways. For example, the handle member 128 has a tab, protrusion, or similar feature or features that can project into one or more channels or slots formed in the housing shaft 121. As illustrated in
The handle member 128 pounds an inner core engagement assembly 139 supported by the handle member 128. As mentioned, the delivery catheter assembly 104 is configured such that, when the inner core member 115 is axially engaged with the handle member 128, any axial movement of the handle member 128 will result in simultaneous axial movement of the inner core member 115 relative to the introducer catheter 102 and the outer sheath 110. Depressing the inner core engagement assembly 139 can release the inner core member 115 from the handle member 128 so that the inner core member 115 can be axially moved relative to the handle member 128. In some configurations, the inner core member 115 can be rotated relative to the handle member 128 even when the inner core member 115 is axially engaged with the handle member 128.
As mentioned, the rotatable adjustment member 130 is supported by the housing shaft 121. The rotatable adjustment member 130 is threadedly engaged with the outer threads on the threaded portion 126 of the handle member 128. In this configuration, rotating or turning the rotatable adjustment member 130 in one direction causes the rotatable adjustment member 130 to advance along the threads and move in an axial direction toward the distal end portion 121a of the housing shaft 121. Rotating or turning the rotatable adjustment member 130 in a second, opposite direction causes the rotatable adjustment member 130 to move in an axial direction away from the distal end portion 121a of the housing shaft 121 of the delivery catheter assembly 104. As a result of the threaded engagement between the rotatable adjustment member 130 and the housing shaft 121, the rotatable adjustment member 130 can be prevented from axially sliding relative to the housing shaft 121. Accordingly, the handle member 128 can axially slide but be prevented from rotating relative to the housing shaft 121, and the rotatable adjustment member 130 can rotate but be prevented from axially sliding relative to the housing shaft 121.
In use, a surgeon may grasp the handle member 128 with one hand (for example, the left hand) and the rotatable adjustment member 130 (which is initially axially positioned adjacent the proximal 130a of the housing shaft) with the other hand. The surgeon moves the inner core member 115 to engage with the handle member 128. To retract the outer sheath 110 of the introducer catheter 102 relative to the inner core member 115, the surgeon holds the handle member 128 in a fixed position while axially withdrawing the housing shaft 121 of the delivery catheter assembly 104, which is axially fixed to the introducer catheter 102 and to outer sheath 110. Holding the handle member 128 in a fixed position, with the inner core engagement (and release) assembly 139 engaged with the inner core member 115, holds the inner core member 115 fixed as the outer sheath 110 is axially retracted relatively inner core member 115 fixed to the housing shaft 121. Retracting the housing shaft 121 portion of the delivery catheter assembly 104 can be done by grasping and rotating the rotatable adjustment member 130 or directly by applying a pull force to retracting the rotatable adjustment member 130 relative to the handle member 128. This step causes withdrawal of the outer sheath 110 relative to the inner core member 115 is desired.
The slower incremental withdrawal of the outer sheath 110 relative to the inner core member 115 is accomplished as the rotatable adjustment member 130 axially abuts a proximal end 128a of the handle member 128. Rotating the rotatable adjustment member 130 in a first direction while holding the handle member 128 in a fixed axial position will slowly and incrementally and controllably retract or withdraw the housing shaft 121 of the delivery catheter assembly 104 and, consequently, the outer sheath 110. This controlled withdrawal of the outer sheath 110 is usually performed during the initial deployment phase of exposing and deploying a stent, to allow the surgeon greater control and accuracy in positioning the stent in the target location.
In sum, in this configuration, with the handle member 128 initially positioned on a proximal portion of the housing shaft 121, a surgeon can controllably retract the outer sheath 110 to expose the stent by holding the handle member 128 in a fixed position relative to the patient in one hand, while using his or her other hand to turn the rotatable adjustment member 130 in a first direction to retract the housing shaft 121 and outer sheath 110 relative to the handle member 128 and inner core member 115. Once the surgeon is confident that the stent is in the desired position, the surgeon can then more rapidly retract the outer sheath 110 relative to the inner core member 115 by grabbing and axially retracting the housing shaft 121 relative to the handle member 128.
As illustrated in
With reference to
The rotatable adjustment member 130 is separable from the handle member 128 so that the adjustment member 130 and housing shaft 121 can move independently of the handle member 128. The adjustment member 130 includes inside threads that engage with the external threads on the threaded portion 126 of the housing shaft 121. Rotating the adjustment member 130 in a first direction axially retracts the housing shaft 121 and sheath as the adjustment member 130 maintains contact with the handle member 128 as the adjustment member rotates. Rotation of the adjustment member 130 is used to control the speed of slow retraction of the housing shaft 121 or an axial force applied to the adjustment member provides the option of a quick retraction.
The handle member 128 is selectively engageable with the inner core member 115.
With reference to
With reference to
The engagement ring 147 is configured to be received by the inner core engagement assembly 139 by sliding the inner core member 115 in a first (distal) direction (represented by arrow Al in
The engagement assembly 139 is further configured so that moving the one or more arms 159 in a radial direction (spreading them, as shown in
Further, with reference to
The stent can be preloaded in the introducer catheter assembly or introducer sheath such that the stent need not be transferred into the catheter assembly or introducer sheath during the surgical operation. The delivery catheter system can have an introducer sheath, inner core, and some or all of the other features of the delivery catheter disclosed herein in one apparatus. In of this inclusive apparatus, the inner core can be permanently joined to the handle member 128 such that there would be no need to configure the delivery catheter to be selectively engageable with the inner core, thereby simplifying the assembly and potentially simplifying the surgical procedures. Therefore, some embodiments of this inclusive delivery catheter assembly, the delivery catheter assembly can have all of the components, features, details, or configurations of the embodiments of the catheter system 100 described above, wherein the inner core engagement assembly 139 and the lock engagement ring 147 of the inner core member 115 can be replaced with a non-selectable coupling or other connection between the inner core member 115 and the handle member 128.
In the configuration shown, the beads or tabs 174 supported by the core wire 117 can engage the struts 216 or connection points 218 of the stent 214 to help prevent the stent from axially slipping relative to the inner core wire 117 for portions of the stent 214 that remain compressed within the outer sheath 110. This arrangement provides greater control over the stent 214 during the final stages of deployment of the stent 214, for example, when only an end portion of the stent 214 remains compressed within the outer sheath 110, as illustrated in
Additionally, positioning the tabs 174 between the struts 216 or connection points 218 can reduce the compressed diameter or crossing profile of the compressed prosthesis, the outer sheath 110, and other components comprising the catheter system. This arrangement can also allow for a more uniform distribution of support forces between the tabs 174, the inner core wire 117, and the stent 214. the tabs 174 can be sized, spaced, and otherwise configured so as to be positioned adjacent to the links, bends, loops, and/or other connectors formed in a tubular or bifurcated stent, such as the links, bends, loops, and/or other connectors comprising the embodiments of the stents disclosed in U.S. Pat. No. 6,077,296, entitled ENDOLUMINAL VASCULAR PROSTHESIS, which patent is hereby incorporated by reference as if fully set forth herein.
In any of the catheter system embodiments disclosed herein, the catheter system can be configured as described herein such that the stent can be compressed from a first diameter or size to a second diameter or size as the stent is being loaded into the introducer or introducer sheath. The first diameter or size can be the fully relaxed or expanded diameter of the stent, or the first diameter or size can be a partially compressed diameter. For example, for some of the embodiments disclosed herein, the stent can be compressed from a first diameter, as defined or controlled by the sheath of the delivery catheter or by an assembly apparatus surrounding the stent, to a second diameter, as defined or controlled by the introducer sheath. The reduction ratios of the stent when advanced into the introducer can be from approximately 50% to approximately 95%, meaning that the second diameter can be from approximately 50% to approximately 95% of the first diameter.
With reference to
The introducer catheter assembly 302 and the delivery catheter can be configured such that the distal end 316a of the sheath 316 terminates prior to or approximately adjacent to the constricted portion of the main body portion 306. In this configuration, the stent can be loaded into the delivery catheter in a relaxed or mostly relaxed (i.e., expanded) state having diameter “a”, and be compressed by the tapered wall portions 314 of the introducer catheter assembly 302 to a final, compressed diameter “b”, thereby reducing the stresses applied to the stent prior to loading the stent in the introducer catheter assembly 302.
The sheaths supported by the delivery catheter, for example sheath 316 or the sheath 127 discussed above, can overlap or be advanceable into at least the proximal portion of the introducer or outer sheath 310, 110, or so that the sheath 316 or the sheath 127 discussed above can be advanceable through the entire length of the introducer or outer sheath 310, 110. A distal portion of the sheath supported by the delivery catheter can be tapered. In this configuration, the stent can be further compressed or compressed as it is being passed through the distal portion of the delivery catheter sheath into the introducer or introducer sheath.
The introducer catheter assembly 302 can be configured to receive and deploy any of a variety of prostheses, including non-bifurcated and bifurcated stents and stent grafts, stent segments, fenestrated stents, and other similar stents or stent grafts disclosed herein or otherwise. The introducer catheter assembly 302 or any other introducer catheter assembly embodiment disclosed herein can be configured to receive and removably couple with any of a variety of delivery catheters, including accessory stent catheters, suprarenal stents or stent extension catheters, or bifurcated stent delivery catheters.
The outer sheath 310 or any other outer sheath embodiment disclosed herein has an inner diameter of approximately 0.237 in. and an outer diameter of approximately 0.253 in. When used for the delivery of a bifurcated stent, the sheath 316 has an inner diameter of approximately 0.251 in. and an outer diameter of approximately 0.263 in. When used for the delivery of an accessory stent or non-bifurcated stent, the sheath 316 has an inner diameter of approximately 0.241 in. and an outer diameter of approximately 0.263 in.
When used for the delivery of a bifurcated stent, the inner core (not illustrated in
The hollow tube 420 can project through an inside lumen of the stent 416 such that a distal end 420a of the hollow tube 420 projects past an end portion 416a of the stent 416. Additionally, the hollow tube 420 has a curved or kinked portion 420b proximal to the end of the stent 416. The outer sheath 410 holds the curved portion 420b of the hollow tube 420 in the curved position or orientation (the first state) so as to mechanically link or lock the inner wire 418 axially to the hollow tube 420 until the curve or bend in the curved portion 420b is relaxed. As will be discussed, the curve or bend in the curved portion 420b can be relaxed by retracting or withdrawing the outer sheath 410 past the curved portion 420b of the hollow tube 420, thereby allowing the hollow tube 420 and inner wire 418 to relax and straighten. Therefore, when the hollow tube 420 is in the first state, the inner wire 418 will be axially fixed to the hollow tube 420 such that the inner wire 418 is axially retracted without becoming disengaged from the hollow tube 420. When the outer sheath 410 is retracted past the curved portion 420b of the hollow tube 420, the hollow tube 420 relaxes so that the curved portion 420b is no longer be axially locked to the inner wire 418. In this second, relaxed state, the inner wire 418 can be axially advanced or retracted into and out of the hollow tube 420.
In this arrangement, the inner wire 418 can be advanced through a first puncture site in a first branch vessel or passageway (such as the ipsilateral iliac artery) and then withdrawn though a second branch vessel or passageway (such as the contralateral iliac artery), using any suitable cross-over techniques. For example, the inner wire can be advanced through the ipsilateral iliac artery in a slitted lumen formed in a dual lumen dilator. The dilator can be withdrawn and set aside, allowing the inner wire 418 to pass through the slit in the lumen of the dual lumen dilator, thereby leaving a proximal end of the inner wire 418 positioned within the abdominal aorta. In this position, the inner wire 418 can be snared and retracted through the contralateral iliac artery and through a second puncture site.
Many embodiments of the catheter system have been described in connection with the accompanying figures. It will apparent to one of ordinary skill in the art that there are many potential embodiments of the catheter system that may be suitable for medical use and which are contemplated herein. For example, any of the components or features of some embodiments of the catheters disclosed herein or other catheters available in the field can be combined to form additional embodiments, all of which are contemplated herein.
While the above description has shown, described, and pointed out features as applied to various embodiments, it will be understood that various omissions, substitutions, and changes in the form and details of the device or process illustrated may be made without departing from the spirit of the disclosure. Additionally, the various features and processes described above may be used independently of one another, or may be combined in various ways. All possible combinations and subcombinations are intended to fall within the scope of this disclosure. Further, as will be recognized, certain embodiments described herein may be embodied within a form that does not provide all of the features and benefits set forth herein, as some features may be used or practiced separately from others.
The present application is a continuation of U.S. patent application Ser. No. 15/379,268, filed Dec. 14, 2016, which is a continuation of U.S. patent application Ser. No. 14/462,485, filed Aug. 18, 2014, now U.S. Pat. No. 9,549,835, which is a divisional of U.S. patent application Ser. No. 13/408,952, filed Feb. 29, 2012, now U.S. Pat. No. 8,808,350, issued Aug. 19, 2014, which claims priority from U.S. Patent Application Ser. No. 61/448,154, filed Mar. 1, 2011, the content of both of which is incorporated by reference herein in its entirety. The benefit of priority is claimed under the appropriate legal basis including, without limitation, under 35 U.S.C. § 119(e).
Number | Name | Date | Kind |
---|---|---|---|
519928 | Schanck | May 1894 | A |
1065935 | Gail | Jul 1913 | A |
2127903 | Bowen | Aug 1938 | A |
2335333 | Wysong | Nov 1943 | A |
2437542 | Krippendorf | May 1944 | A |
2845959 | Sidebotham | Aug 1958 | A |
2990605 | Demsyk | Jul 1961 | A |
3029819 | Starks | Apr 1962 | A |
3096560 | Liebig | Jul 1963 | A |
3245703 | Manly | Apr 1966 | A |
3805301 | Liebig | Apr 1974 | A |
3994149 | Dahlman | Nov 1976 | A |
4362156 | Feller, Jr. et al. | Dec 1982 | A |
4473067 | Schiff | Sep 1984 | A |
4497074 | Ray et al. | Feb 1985 | A |
4501263 | Harbuck | Feb 1985 | A |
4503568 | Madras | Mar 1985 | A |
4525157 | Vaillancourt | Jun 1985 | A |
4562596 | Kornberg | Jan 1986 | A |
4580568 | Gianturco | Apr 1986 | A |
4592754 | Gupte et al. | Jun 1986 | A |
4617932 | Kornberg | Oct 1986 | A |
4723550 | Bales et al. | Feb 1988 | A |
4723938 | Goodin et al. | Feb 1988 | A |
4756307 | Crownshield | Jul 1988 | A |
4768507 | Fischell et al. | Sep 1988 | A |
4772266 | Groshong | Sep 1988 | A |
4795465 | Marten | Jan 1989 | A |
4800882 | Gianturco | Jan 1989 | A |
4816028 | Kapadia et al. | Mar 1989 | A |
4840940 | Sottiurai | Jun 1989 | A |
4856516 | Hillstead | Aug 1989 | A |
4878906 | Lindemann et al. | Nov 1989 | A |
4907336 | Gianturco | Mar 1990 | A |
4917668 | Haindl | Apr 1990 | A |
4922905 | Strecker | May 1990 | A |
4960412 | Fink | Oct 1990 | A |
4978334 | Toye et al. | Dec 1990 | A |
4981478 | Evard et al. | Jan 1991 | A |
4981947 | Tomagou et al. | Jan 1991 | A |
4994069 | Ritchrt et al. | Feb 1991 | A |
4994071 | MacGregor | Feb 1991 | A |
5019090 | Pinchuk | May 1991 | A |
5026377 | Burton et al. | Jun 1991 | A |
5035706 | Giantureo et al. | Jul 1991 | A |
5064414 | Revane | Nov 1991 | A |
5064435 | Porter | Nov 1991 | A |
5078726 | Kreamer | Jan 1992 | A |
5084010 | Plaia et al. | Jan 1992 | A |
5098392 | Fleischhacker et al. | Mar 1992 | A |
5098395 | Fields | Mar 1992 | A |
5104399 | Lazarus | Apr 1992 | A |
5108380 | Herlitze et al. | Apr 1992 | A |
5108424 | Hoffman, Jr. et al. | Apr 1992 | A |
5116349 | Aranyi | May 1992 | A |
5123917 | Lee | Jun 1992 | A |
5133732 | Wiktor | Jul 1992 | A |
5135535 | Kramer | Aug 1992 | A |
5135536 | Hillstead | Aug 1992 | A |
5137519 | Littrell et al. | Aug 1992 | A |
5141497 | Erskine | Aug 1992 | A |
5151105 | Kwan-Gett | Sep 1992 | A |
5156619 | Ehrenfeld | Oct 1992 | A |
5178634 | Martinez | Jan 1993 | A |
5186712 | Kelso et al. | Feb 1993 | A |
5195978 | Schiffer | Mar 1993 | A |
5195980 | Catlin | Mar 1993 | A |
5197976 | Herweck et al. | Mar 1993 | A |
5201757 | Heyn et al. | Apr 1993 | A |
5203774 | Gilson et al. | Apr 1993 | A |
5205829 | Lituchy | Apr 1993 | A |
5211658 | Clouse | May 1993 | A |
5222969 | Gillis | Jun 1993 | A |
5250036 | Farivar | Oct 1993 | A |
5256141 | Gancheff et al. | Oct 1993 | A |
5263932 | Jang | Nov 1993 | A |
5267982 | Sylvanowicz | Dec 1993 | A |
5275622 | Lazarus et al. | Jan 1994 | A |
5279592 | Amor et al. | Jan 1994 | A |
5282824 | Gianturco | Feb 1994 | A |
5282860 | Matsuno et al. | Feb 1994 | A |
5290310 | Makower et al. | Mar 1994 | A |
5304200 | Spaulding | Apr 1994 | A |
5314444 | Gianturco | May 1994 | A |
5314472 | Fontaine | May 1994 | A |
5316023 | Palmaz et al. | May 1994 | A |
5320602 | Karpeil | Jun 1994 | A |
5324306 | Makower et al. | Jun 1994 | A |
5330500 | Song | Jul 1994 | A |
5334157 | Klein et al. | Aug 1994 | A |
5342387 | Summers | Aug 1994 | A |
5350397 | Palermo et al. | Sep 1994 | A |
5354308 | Simon et al. | Oct 1994 | A |
5360443 | Barone et al. | Nov 1994 | A |
5366504 | Andersen et al. | Nov 1994 | A |
5370683 | Fontaine | Dec 1994 | A |
5376077 | Gomringer | Dec 1994 | A |
5383892 | Cardon et al. | Jan 1995 | A |
5387235 | Chuter | Feb 1995 | A |
5389087 | Miraki | Feb 1995 | A |
5391152 | Patterson | Feb 1995 | A |
5397310 | Chu et al. | Mar 1995 | A |
5397355 | Marin et al. | Mar 1995 | A |
5403283 | Luther | Apr 1995 | A |
5403341 | Solar | Apr 1995 | A |
5405323 | Rogers et al. | Apr 1995 | A |
5405377 | Cragg | Apr 1995 | A |
5405378 | Strecker | Apr 1995 | A |
5415664 | Pinchuk | May 1995 | A |
5423886 | Arru et al. | Jun 1995 | A |
5425765 | Tiefenbrun et al. | Jun 1995 | A |
5443477 | Marin et al. | Aug 1995 | A |
5443498 | Fontaine | Aug 1995 | A |
5443500 | Sigwart | Aug 1995 | A |
5453090 | Martinez et al. | Sep 1995 | A |
5456713 | Chuter | Oct 1995 | A |
5458615 | Klemm et al. | Oct 1995 | A |
5462530 | Jang | Oct 1995 | A |
5464449 | Ryan et al. | Nov 1995 | A |
5464450 | Buscemi et al. | Nov 1995 | A |
5464499 | Moslehi et al. | Nov 1995 | A |
5472417 | Martin et al. | Dec 1995 | A |
5484444 | Braunschweiler et al. | Jan 1996 | A |
5489295 | Piplani et al. | Feb 1996 | A |
5496365 | Sgro | Mar 1996 | A |
5505710 | Dorsey, III | Apr 1996 | A |
5507727 | Crainich | Apr 1996 | A |
5507767 | Maeda et al. | Apr 1996 | A |
5507768 | Lau et al. | Apr 1996 | A |
5507769 | Marin et al. | Apr 1996 | A |
5507771 | Gianturco | Apr 1996 | A |
5522880 | Barone et al. | Jun 1996 | A |
5522881 | Lentz | Jun 1996 | A |
5522883 | Slater et al. | Jun 1996 | A |
5545152 | Funderburk et al. | Aug 1996 | A |
5545211 | An et al. | Aug 1996 | A |
5549635 | Solar | Aug 1996 | A |
5554118 | Jang | Sep 1996 | A |
5554181 | Das | Sep 1996 | A |
5562697 | Christiansen | Oct 1996 | A |
5562726 | Chuter | Oct 1996 | A |
5562728 | Lazarus et al. | Oct 1996 | A |
5571169 | Plaia et al. | Nov 1996 | A |
5571172 | Chin | Nov 1996 | A |
5571173 | Parodi | Nov 1996 | A |
5575816 | Rudnick et al. | Nov 1996 | A |
5575818 | Pinchuk | Nov 1996 | A |
5578071 | Parodi | Nov 1996 | A |
5578072 | Barone et al. | Nov 1996 | A |
5591195 | Taheri et al. | Jan 1997 | A |
5591197 | Orth et al. | Jan 1997 | A |
5591198 | Boyle et al. | Jan 1997 | A |
5591226 | Trerotola et al. | Jan 1997 | A |
5591228 | Edoga | Jan 1997 | A |
5591229 | Parodi | Jan 1997 | A |
5591230 | Horn et al. | Jan 1997 | A |
5593417 | Rhodes | Jan 1997 | A |
5599305 | Hermann et al. | Feb 1997 | A |
5604435 | Foo et al. | Feb 1997 | A |
5607445 | Summers | Mar 1997 | A |
5609625 | Piplani et al. | Mar 1997 | A |
5609627 | Goicoechea et al. | Mar 1997 | A |
5609628 | Keranen | Mar 1997 | A |
5628755 | Heller et al. | May 1997 | A |
5628783 | Quiachon et al. | May 1997 | A |
5628786 | Banas et al. | May 1997 | A |
5628788 | Pinchuk | May 1997 | A |
5630829 | Lauterjung | May 1997 | A |
5630830 | Verbeek | May 1997 | A |
5632763 | Glastra | May 1997 | A |
5632772 | Alcime et al. | May 1997 | A |
5634928 | Fischell et al. | Jun 1997 | A |
5639278 | Dereume et al. | Jun 1997 | A |
5641373 | Shannon et al. | Jun 1997 | A |
5643171 | Bradshaw et al. | Jul 1997 | A |
5643278 | Wijay | Jul 1997 | A |
5643339 | Kavteladze et al. | Jul 1997 | A |
5647857 | Anderson et al. | Jul 1997 | A |
5649952 | Lam | Jul 1997 | A |
5651174 | Schwartz et al. | Jul 1997 | A |
5653727 | Wiktor | Aug 1997 | A |
5653743 | Martin | Aug 1997 | A |
5653746 | Schmitt | Aug 1997 | A |
5653747 | Dereume | Aug 1997 | A |
5653748 | Strecker | Aug 1997 | A |
5662580 | Bradshaw et al. | Sep 1997 | A |
5662614 | Edoga | Sep 1997 | A |
5662675 | Polanskyj Stockert et al. | Sep 1997 | A |
5662700 | Lazarus | Sep 1997 | A |
5662701 | Plaia et al. | Sep 1997 | A |
5662702 | Keranen | Sep 1997 | A |
5662703 | Yurek et al. | Sep 1997 | A |
5665115 | Cragg | Sep 1997 | A |
5665117 | Rhodes | Sep 1997 | A |
5669880 | Solar | Sep 1997 | A |
5669924 | Shaknovich | Sep 1997 | A |
5669934 | Sawyer | Sep 1997 | A |
5674241 | Bley et al. | Oct 1997 | A |
5674276 | Andersen et al. | Oct 1997 | A |
5676671 | Inoue | Oct 1997 | A |
5676685 | Razaivi | Oct 1997 | A |
5676696 | Marcade | Oct 1997 | A |
5676697 | McDonald | Oct 1997 | A |
5679400 | Tuch | Oct 1997 | A |
5681345 | Tuteneuer | Oct 1997 | A |
5681346 | Orth et al. | Oct 1997 | A |
5683448 | Cragg | Nov 1997 | A |
5683449 | Marcade | Nov 1997 | A |
5683450 | Goicoechea et al. | Nov 1997 | A |
5683451 | Lenker et al. | Nov 1997 | A |
5683452 | Barone et al. | Nov 1997 | A |
5683453 | Palmaz | Nov 1997 | A |
5690642 | Osborne et al. | Nov 1997 | A |
5690643 | Wijay | Nov 1997 | A |
5690644 | Yurek et al. | Nov 1997 | A |
5693066 | Rupp et al. | Dec 1997 | A |
5693084 | Chuter | Dec 1997 | A |
5693086 | Goicoechea et al. | Dec 1997 | A |
5693087 | Parodi | Dec 1997 | A |
5693088 | Lazarus | Dec 1997 | A |
5695516 | Fischell et al. | Dec 1997 | A |
5695517 | Marin et al. | Dec 1997 | A |
5697948 | Marin et al. | Dec 1997 | A |
5697971 | Fischell et al. | Dec 1997 | A |
5700269 | Pinchuk et al. | Dec 1997 | A |
5707354 | Salmon et al. | Jan 1998 | A |
5709703 | Lukic et al. | Jan 1998 | A |
5713917 | Leonhardt | Feb 1998 | A |
5716365 | Goicoechea et al. | Feb 1998 | A |
5716393 | Lindenberg et al. | Feb 1998 | A |
5718724 | Goicoechea et al. | Feb 1998 | A |
5718973 | Lewis et al. | Feb 1998 | A |
5720735 | Dorros | Feb 1998 | A |
5720776 | Chuter et al. | Feb 1998 | A |
5723004 | Dereume et al. | Mar 1998 | A |
5725519 | Penner et al. | Mar 1998 | A |
5733267 | Del Toro | Mar 1998 | A |
5733325 | Robinson et al. | Mar 1998 | A |
5738660 | Luther | Apr 1998 | A |
5738674 | Williams et al. | Apr 1998 | A |
5741233 | Riddle et al. | Apr 1998 | A |
5746766 | Edoga | May 1998 | A |
5746776 | Smith et al. | May 1998 | A |
5749880 | Banas et al. | May 1998 | A |
5749921 | Lenker et al. | May 1998 | A |
5755735 | Richter et al. | May 1998 | A |
5755770 | Ravenscroft | May 1998 | A |
5755771 | Penn et al. | May 1998 | A |
5755777 | Chuter | May 1998 | A |
5765682 | Bley et al. | Jun 1998 | A |
5766203 | Imran et al. | Jun 1998 | A |
5769885 | Quiachon et al. | Jun 1998 | A |
5769887 | Brown et al. | Jun 1998 | A |
5772636 | Brimhall et al. | Jun 1998 | A |
5776142 | Gunderson | Jul 1998 | A |
5782807 | Falvai et al. | Jul 1998 | A |
5782817 | Franzel et al. | Jul 1998 | A |
5782855 | Lau et al. | Jul 1998 | A |
5782909 | Quiachon et al. | Jul 1998 | A |
5788707 | Del Toro et al. | Aug 1998 | A |
5797952 | Klein | Aug 1998 | A |
5800456 | Maeda et al. | Sep 1998 | A |
5800508 | Goicoechea et al. | Sep 1998 | A |
5800517 | Anderson et al. | Sep 1998 | A |
5800526 | Anderson et al. | Sep 1998 | A |
5800540 | Chin | Sep 1998 | A |
5810836 | Hussein et al. | Sep 1998 | A |
5810873 | Morales | Sep 1998 | A |
5817100 | Igaki | Oct 1998 | A |
5824037 | Fogarty et al. | Oct 1998 | A |
5824039 | Piplani et al. | Oct 1998 | A |
5824040 | Cox et al. | Oct 1998 | A |
5824041 | Lenker et al. | Oct 1998 | A |
5824053 | Khosravi et al. | Oct 1998 | A |
5843046 | Motisi et al. | Dec 1998 | A |
5843092 | Heller et al. | Dec 1998 | A |
5843160 | Rhodes | Dec 1998 | A |
5843162 | Inoue | Dec 1998 | A |
5843164 | Frantzen et al. | Dec 1998 | A |
5843167 | Dwyer et al. | Dec 1998 | A |
5851228 | Pinheiro | Dec 1998 | A |
5855599 | Wan | Jan 1999 | A |
5860998 | Robinson et al. | Jan 1999 | A |
5865844 | Plaia et al. | Feb 1999 | A |
5867432 | Toda | Feb 1999 | A |
5868783 | Tower | Feb 1999 | A |
5871536 | Lazarus | Feb 1999 | A |
5876432 | Lau et al. | Mar 1999 | A |
5879321 | Hill | Mar 1999 | A |
5879333 | Smith | Mar 1999 | A |
5879334 | Brimhall | Mar 1999 | A |
5879366 | Shaw et al. | Mar 1999 | A |
5885217 | Gisselberg et al. | Mar 1999 | A |
5891193 | Robinson et al. | Apr 1999 | A |
5893868 | Hanson et al. | Apr 1999 | A |
5893887 | Jayaraman | Apr 1999 | A |
5902334 | Dwyer et al. | May 1999 | A |
5906619 | Olson et al. | May 1999 | A |
5906640 | Penn et al. | May 1999 | A |
5906641 | Thompson et al. | May 1999 | A |
5910145 | Fischell et al. | Jun 1999 | A |
5911700 | Mozsary et al. | Jun 1999 | A |
5911710 | Barry et al. | Jun 1999 | A |
5911752 | Dustrude et al. | Jun 1999 | A |
5916263 | Goicoceha et al. | Jun 1999 | A |
5919225 | Lau et al. | Jul 1999 | A |
5925075 | Myers et al. | Jul 1999 | A |
5925076 | Inoe | Jul 1999 | A |
5928279 | Shannon et al. | Jul 1999 | A |
5935135 | Bramfitt et al. | Aug 1999 | A |
5935161 | Robinson et al. | Aug 1999 | A |
5938696 | Goicoechea et al. | Aug 1999 | A |
5948018 | Dereume et al. | Sep 1999 | A |
5954729 | Bachmann et al. | Sep 1999 | A |
5957973 | Quiachon et al. | Sep 1999 | A |
5961546 | Robinson et al. | Oct 1999 | A |
5961548 | Shmulewitz | Oct 1999 | A |
5971958 | Zhang | Oct 1999 | A |
5976153 | Fischell et al. | Nov 1999 | A |
5976155 | Foreman et al. | Nov 1999 | A |
5997562 | Zadno-Azizi et al. | Dec 1999 | A |
6001125 | Golds et al. | Dec 1999 | A |
6004294 | Brimhall et al. | Dec 1999 | A |
6004347 | McNamara et al. | Dec 1999 | A |
6004348 | Banas et al. | Dec 1999 | A |
6017363 | Hojeibane | Jan 2000 | A |
6019777 | Mackenzie | Feb 2000 | A |
6019785 | Strecker | Feb 2000 | A |
6027508 | Ren et al. | Feb 2000 | A |
6027779 | Campbell et al. | Feb 2000 | A |
6027811 | Campbell et al. | Feb 2000 | A |
6030414 | Taheri | Feb 2000 | A |
6030415 | Chuter | Feb 2000 | A |
6033413 | Mikus et al. | Mar 2000 | A |
6039749 | Marin et al. | Mar 2000 | A |
6039755 | Edwin et al. | Mar 2000 | A |
6039758 | Quiachon et al. | Mar 2000 | A |
6045557 | White et al. | Apr 2000 | A |
6051020 | Goicoechea et al. | Apr 2000 | A |
6053940 | Wijay | Apr 2000 | A |
6056722 | Jayaraman | May 2000 | A |
6059813 | Vrba et al. | May 2000 | A |
6059824 | Taheri | May 2000 | A |
6063092 | Shin | May 2000 | A |
6063113 | Kavteladze et al. | May 2000 | A |
6068635 | Gianotti | May 2000 | A |
6070589 | Keith et al. | Jun 2000 | A |
6074398 | Leschinsky | Jun 2000 | A |
6077295 | Limon et al. | Jun 2000 | A |
6077296 | Shokoohi et al. | Jun 2000 | A |
6077297 | Robinson et al. | Jun 2000 | A |
6080191 | Summers | Jun 2000 | A |
6086611 | Duffy et al. | Jul 2000 | A |
6090128 | Douglas | Jul 2000 | A |
6090135 | Plaia et al. | Jul 2000 | A |
6093194 | Mikus et al. | Jul 2000 | A |
6093203 | Uflacker | Jul 2000 | A |
6096005 | Botich et al. | Aug 2000 | A |
6096027 | Layne | Aug 2000 | A |
6106548 | Reubin et al. | Aug 2000 | A |
6110180 | Foreman et al. | Aug 2000 | A |
6113607 | Lau et al. | Sep 2000 | A |
6117142 | Goodson et al. | Sep 2000 | A |
6117167 | Goicoechea et al. | Sep 2000 | A |
6123722 | Fogarty et al. | Sep 2000 | A |
6123723 | Konya et al. | Sep 2000 | A |
6126685 | Lenker et al. | Oct 2000 | A |
6129756 | Kugler et al. | Oct 2000 | A |
6132458 | Stachle et al. | Oct 2000 | A |
6139532 | Howell et al. | Oct 2000 | A |
6143016 | Bleam et al. | Nov 2000 | A |
6146389 | Geitz | Nov 2000 | A |
6146415 | Fitz | Nov 2000 | A |
6149680 | Shelso et al. | Nov 2000 | A |
6152944 | Holman et al. | Nov 2000 | A |
6159195 | Ha et al. | Dec 2000 | A |
6159198 | Gardeski et al. | Dec 2000 | A |
6162237 | Chan | Dec 2000 | A |
6165195 | Wilson et al. | Dec 2000 | A |
6165214 | Lazarus | Dec 2000 | A |
6168610 | Marin et al. | Jan 2001 | B1 |
6171281 | Zhang | Jan 2001 | B1 |
6174327 | Mertens et al. | Jan 2001 | B1 |
6174329 | Callol et al. | Jan 2001 | B1 |
6183443 | Kratoska et al. | Feb 2001 | B1 |
6183481 | Lee et al. | Feb 2001 | B1 |
6183509 | Dibie | Feb 2001 | B1 |
6187036 | Shaolian et al. | Feb 2001 | B1 |
6187037 | Satz | Feb 2001 | B1 |
6192944 | Greenhalgh | Feb 2001 | B1 |
6193726 | Vanney | Feb 2001 | B1 |
6197007 | Thorne et al. | Mar 2001 | B1 |
6197016 | Fourkas et al. | Mar 2001 | B1 |
6197049 | Shaolian et al. | Mar 2001 | B1 |
6203735 | Edwin et al. | Mar 2001 | B1 |
6210429 | Vardi et al. | Apr 2001 | B1 |
6214038 | Piplani et al. | Apr 2001 | B1 |
6221081 | Mikus et al. | Apr 2001 | B1 |
6221090 | Wilson | Apr 2001 | B1 |
6221098 | Wilson | Apr 2001 | B1 |
6221102 | Baker et al. | Apr 2001 | B1 |
6224627 | Armstrong et al. | May 2001 | B1 |
6228062 | Howell et al. | May 2001 | B1 |
6231563 | White et al. | May 2001 | B1 |
6238410 | Vrba et al. | May 2001 | B1 |
6254609 | Vrba et al. | Jul 2001 | B1 |
6254628 | Wallace et al. | Jul 2001 | B1 |
6258099 | Mareiro et al. | Jul 2001 | B1 |
6261316 | Shaolian et al. | Jul 2001 | B1 |
6264682 | Wilson et al. | Jul 2001 | B1 |
6273895 | Pinchuk et al. | Aug 2001 | B1 |
6273909 | Kugler et al. | Aug 2001 | B1 |
6280466 | Kugler et al. | Aug 2001 | B1 |
6280467 | Leonhardt | Aug 2001 | B1 |
6283991 | Cox et al. | Sep 2001 | B1 |
6287329 | Duering et al. | Sep 2001 | B1 |
6299634 | Bergeron | Oct 2001 | B1 |
6302893 | Limon et al. | Oct 2001 | B1 |
6312406 | Jayaraman | Nov 2001 | B1 |
6331184 | Abrams | Dec 2001 | B1 |
6331190 | Shokoohi et al. | Dec 2001 | B1 |
6348066 | Pinchuk et al. | Feb 2002 | B1 |
6350278 | Lenker et al. | Feb 2002 | B1 |
6352553 | Van der Burg et al. | Mar 2002 | B1 |
6352561 | Leopold et al. | Mar 2002 | B1 |
6355060 | Lenker et al. | Mar 2002 | B1 |
6361544 | Wilson et al. | Mar 2002 | B1 |
6361555 | Wilson | Mar 2002 | B1 |
6361557 | Gittings et al. | Mar 2002 | B1 |
6361559 | Houser et al. | Mar 2002 | B1 |
6361637 | Martin et al. | Mar 2002 | B2 |
6379365 | Diaz | Apr 2002 | B1 |
6380457 | Yurek et al. | Apr 2002 | B1 |
6383213 | Wilson et al. | May 2002 | B2 |
6387120 | Wilson et al. | May 2002 | B2 |
6395017 | Dwyer et al. | May 2002 | B1 |
6395018 | Castaneda | May 2002 | B1 |
6395019 | Chobotov | May 2002 | B2 |
6398807 | Chouinard et al. | Jun 2002 | B1 |
6409750 | Hyodoh et al. | Jun 2002 | B1 |
6409757 | Trout, III et al. | Jun 2002 | B1 |
6416474 | Penner et al. | Jul 2002 | B1 |
6416529 | Holman et al. | Jul 2002 | B1 |
6416542 | Marcade et al. | Jul 2002 | B1 |
6428567 | Wilson et al. | Aug 2002 | B2 |
6432130 | Hanson | Aug 2002 | B1 |
6432131 | Ravenscroft | Aug 2002 | B1 |
6432134 | Anson et al. | Aug 2002 | B1 |
6440161 | Madrid et al. | Aug 2002 | B1 |
6447540 | Fontaine et al. | Sep 2002 | B1 |
6451043 | McInnes et al. | Sep 2002 | B1 |
6464721 | Marcade et al. | Oct 2002 | B1 |
6468298 | Pelton | Oct 2002 | B1 |
6475166 | Escano | Nov 2002 | B1 |
6475170 | Doron et al. | Nov 2002 | B1 |
6478777 | Honeck et al. | Nov 2002 | B1 |
6482211 | Choi | Nov 2002 | B1 |
6485513 | Fan | Nov 2002 | B1 |
6491719 | Fogrty et al. | Dec 2002 | B1 |
6500202 | Shaolian et al. | Dec 2002 | B1 |
6508790 | Lawrence | Jan 2003 | B1 |
6508833 | Pavcnick et al. | Jan 2003 | B2 |
6508835 | Shaolian et al. | Jan 2003 | B1 |
6508836 | Wilson et al. | Jan 2003 | B2 |
6511325 | Lalka et al. | Jan 2003 | B1 |
6514281 | Blaeser et al. | Feb 2003 | B1 |
6517522 | Bell et al. | Feb 2003 | B1 |
6517569 | Mikus et al. | Feb 2003 | B2 |
6517572 | Kugler et al. | Feb 2003 | B2 |
6517573 | Pollock et al. | Feb 2003 | B1 |
6520988 | Colombo et al. | Feb 2003 | B1 |
6524335 | Hartley et al. | Feb 2003 | B1 |
6533811 | Ryan et al. | Mar 2003 | B1 |
6544278 | Vrba et al. | Apr 2003 | B1 |
6551350 | Thornton et al. | Apr 2003 | B1 |
6554848 | Boylan et al. | Apr 2003 | B2 |
6558396 | Inoue | May 2003 | B1 |
6562063 | Euteneurer et al. | May 2003 | B1 |
6565596 | White et al. | May 2003 | B1 |
6565597 | Fearnot et al. | May 2003 | B1 |
6569192 | Foreman et al. | May 2003 | B1 |
RE38146 | Palmaz et al. | Jun 2003 | E |
6572643 | Gharibadeh | Jun 2003 | B1 |
6572645 | Leonhardt | Jun 2003 | B2 |
6576005 | Geitz | Jun 2003 | B1 |
6576006 | Limon et al. | Jun 2003 | B2 |
6576009 | Ryan et al. | Jun 2003 | B2 |
6579312 | Wilson et al. | Jun 2003 | B2 |
6582390 | Sanderson | Jun 2003 | B1 |
6582394 | Reiss et al. | Jun 2003 | B1 |
6582459 | Lau et al. | Jun 2003 | B1 |
6582460 | Cryer | Jun 2003 | B1 |
6585758 | Chouinard et al. | Jul 2003 | B1 |
6589213 | Reydel | Jul 2003 | B2 |
6589251 | Yee et al. | Jul 2003 | B2 |
6589262 | Honebrink et al. | Jul 2003 | B1 |
6592548 | Jayaraman | Jul 2003 | B2 |
6592581 | Bowe | Jul 2003 | B2 |
6592614 | Lenker et al. | Jul 2003 | B2 |
6592615 | Marcade et al. | Jul 2003 | B1 |
6599315 | Wilson | Jul 2003 | B2 |
6602280 | Chobotov | Aug 2003 | B2 |
6607551 | Sullivan et al. | Aug 2003 | B1 |
6607552 | Hanson | Aug 2003 | B1 |
6613073 | White et al. | Sep 2003 | B1 |
6613075 | Healy et al. | Sep 2003 | B1 |
6616675 | Evard et al. | Sep 2003 | B1 |
6620191 | Svensson | Sep 2003 | B1 |
6641564 | Kraus | Nov 2003 | B1 |
6652492 | Bell et al. | Nov 2003 | B1 |
6652579 | Cox et al. | Nov 2003 | B1 |
6656213 | Solem | Dec 2003 | B2 |
6660030 | Shaolian et al. | Dec 2003 | B2 |
6663665 | Shaolian et al. | Dec 2003 | B2 |
6669716 | Gilson et al. | Dec 2003 | B1 |
6669718 | Besselink | Dec 2003 | B2 |
6669719 | Wallace et al. | Dec 2003 | B2 |
6673102 | Vonesh et al. | Jan 2004 | B1 |
6676666 | Vrba et al. | Jan 2004 | B2 |
6676667 | Mareiro et al. | Jan 2004 | B2 |
6689157 | Madrid et al. | Feb 2004 | B2 |
6699274 | Stinson | Mar 2004 | B2 |
6699275 | Knudson et al. | Mar 2004 | B1 |
6702843 | Brown et al. | Mar 2004 | B1 |
6702845 | Cully et al. | Mar 2004 | B1 |
6722705 | Korkor | Apr 2004 | B2 |
6723075 | Davey et al. | Apr 2004 | B2 |
6733523 | Shaolian et al. | May 2004 | B2 |
6743210 | Hart et al. | Jun 2004 | B2 |
6749627 | Thompson et al. | Jun 2004 | B2 |
6752819 | Brady et al. | Jun 2004 | B1 |
6755855 | Yurek et al. | Jun 2004 | B2 |
6761733 | Chobotov et al. | Jul 2004 | B2 |
6767359 | Weadock | Jul 2004 | B2 |
6790224 | Gerberding | Sep 2004 | B2 |
6792979 | Konya et al. | Sep 2004 | B2 |
6800065 | Duane et al. | Oct 2004 | B2 |
6808509 | Davey | Oct 2004 | B1 |
6808520 | Fourkas et al. | Oct 2004 | B1 |
6814752 | Chuter | Nov 2004 | B1 |
6818014 | Brown et al. | Nov 2004 | B2 |
6821292 | Pazienza et al. | Nov 2004 | B2 |
6827726 | Parodi | Dec 2004 | B2 |
6840950 | Standford et al. | Jan 2005 | B2 |
6846316 | Abrams | Jan 2005 | B2 |
6849084 | Rabkin et al. | Feb 2005 | B2 |
6849086 | Cragg | Feb 2005 | B2 |
6858038 | Heuser | Feb 2005 | B2 |
6866669 | Buzzard et al. | Mar 2005 | B2 |
6872193 | Shaw et al. | Mar 2005 | B2 |
6875229 | Wilson et al. | Apr 2005 | B2 |
6878158 | Shin et al. | Apr 2005 | B2 |
6887249 | Houser et al. | May 2005 | B1 |
6887251 | Suval | May 2005 | B1 |
6887256 | Gilson et al. | May 2005 | B2 |
6896699 | Wilson et al. | May 2005 | B2 |
6899727 | Armstrong et al. | May 2005 | B2 |
6899728 | Phillips et al. | May 2005 | B1 |
6908477 | McGuckin | Jun 2005 | B2 |
6911039 | Shiu et al. | Jun 2005 | B2 |
6918925 | Tehrani | Jul 2005 | B2 |
6923829 | Boyle et al. | Aug 2005 | B2 |
6926732 | Derus et al. | Aug 2005 | B2 |
6929661 | Bolduc et al. | Aug 2005 | B2 |
6932837 | Amplatz et al. | Aug 2005 | B2 |
6939352 | Buzzard et al. | Sep 2005 | B2 |
6939368 | Simso | Sep 2005 | B2 |
6939370 | Hartley et al. | Sep 2005 | B2 |
6939371 | Kugler et al. | Sep 2005 | B2 |
6939377 | Jayaraman et al. | Sep 2005 | B2 |
6942691 | Chuter | Sep 2005 | B1 |
6942692 | Landau et al. | Sep 2005 | B2 |
6942693 | Chouinard et al. | Sep 2005 | B2 |
6945990 | Greenean | Sep 2005 | B2 |
6953475 | Shaolian et al. | Oct 2005 | B2 |
6955679 | Hendricksen et al. | Oct 2005 | B1 |
6955688 | Wilson et al. | Oct 2005 | B2 |
6960217 | Bolduc | Nov 2005 | B2 |
6962602 | Vardi | Nov 2005 | B2 |
6981982 | Armstrong et al. | Jan 2006 | B2 |
6984244 | Perez et al. | Jan 2006 | B2 |
6991639 | Holman et al. | Jan 2006 | B2 |
6994722 | DiCarlo | Feb 2006 | B2 |
7004926 | Navia et al. | Feb 2006 | B2 |
7004964 | Thompson et al. | Feb 2006 | B2 |
7004967 | Chouinard et al. | Feb 2006 | B2 |
7014653 | Ouriel et al. | Mar 2006 | B2 |
7022133 | Yee et al. | Apr 2006 | B2 |
7025773 | Gittings et al. | Apr 2006 | B2 |
7025779 | Elliott | Apr 2006 | B2 |
7029496 | Rakos et al. | Apr 2006 | B2 |
7052511 | Weldon et al. | May 2006 | B2 |
7056323 | Mareiro et al. | Jun 2006 | B2 |
7074236 | Rabkin et al. | Jul 2006 | B2 |
7096554 | Austin et al. | Aug 2006 | B2 |
7101390 | Nelson | Sep 2006 | B2 |
7105016 | Shiu et al. | Sep 2006 | B2 |
7105017 | Kerr | Sep 2006 | B2 |
7122051 | Dallara et al. | Oct 2006 | B1 |
7122052 | Greenhalgh | Oct 2006 | B2 |
7125464 | Chobotov et al. | Oct 2006 | B2 |
7127789 | Stinson | Oct 2006 | B2 |
7137993 | Acosta et al. | Nov 2006 | B2 |
7144422 | Rao | Dec 2006 | B1 |
7160318 | Greenberg et al. | Jan 2007 | B2 |
7162302 | Wang et al. | Jan 2007 | B2 |
7163715 | Kramer | Jan 2007 | B1 |
7172577 | Mangano et al. | Feb 2007 | B2 |
7175651 | Kerr | Feb 2007 | B2 |
7175652 | Cook et al. | Feb 2007 | B2 |
7175657 | Khan et al. | Feb 2007 | B2 |
7189256 | Smith | Mar 2007 | B2 |
7189257 | Schmitt et al. | Mar 2007 | B2 |
7201770 | Johnson et al. | Apr 2007 | B2 |
7229472 | DePalma et al. | Jun 2007 | B2 |
7235095 | Haverkost et al. | Jun 2007 | B2 |
7241308 | Andreas et al. | Jul 2007 | B2 |
7244444 | Bates | Jul 2007 | B2 |
7261733 | Brown et al. | Aug 2007 | B1 |
7264631 | DeCarlo | Sep 2007 | B2 |
7264632 | Wright et al. | Sep 2007 | B2 |
7267685 | Butaric et al. | Sep 2007 | B2 |
7270675 | Chun et al. | Sep 2007 | B2 |
7285130 | Austin | Oct 2007 | B2 |
7297156 | Nelson | Nov 2007 | B2 |
7300454 | Park et al. | Nov 2007 | B2 |
7314481 | Karpiel | Jan 2008 | B2 |
7314483 | Landau et al. | Jan 2008 | B2 |
7316708 | Gordon et al. | Jan 2008 | B2 |
7320703 | DiMatteo et al. | Jan 2008 | B2 |
7331980 | Dubrul et al. | Feb 2008 | B2 |
7367980 | Kida et al. | May 2008 | B2 |
7381216 | Buzzard et al. | Jun 2008 | B2 |
7402168 | Acosta et al. | Jul 2008 | B2 |
7407509 | Greenberg et al. | Aug 2008 | B2 |
7413560 | Chong et al. | Aug 2008 | B2 |
7419501 | Chiu et al. | Sep 2008 | B2 |
7425219 | Quadri et al. | Sep 2008 | B2 |
7435253 | Hartley et al. | Oct 2008 | B1 |
7473271 | Gunderson | Jan 2009 | B2 |
7476244 | Buzzard et al. | Jan 2009 | B2 |
7481805 | Magnusson | Jan 2009 | B2 |
7491230 | Holman et al. | Feb 2009 | B2 |
7520895 | Douglas et al. | Apr 2009 | B2 |
7526849 | Serrano | May 2009 | B2 |
7537606 | Hartley | May 2009 | B2 |
7553324 | Andreas et al. | Jun 2009 | B2 |
7572289 | Sisken et al. | Aug 2009 | B2 |
7578838 | Melsheimer | Aug 2009 | B2 |
7578841 | Yadin et al. | Aug 2009 | B2 |
7591832 | Eversull et al. | Sep 2009 | B2 |
7618398 | Holman et al. | Nov 2009 | B2 |
7632299 | Weber | Dec 2009 | B2 |
7635382 | Pryor | Dec 2009 | B2 |
7635383 | Gumm | Dec 2009 | B2 |
7637932 | Bolduc et al. | Dec 2009 | B2 |
7641684 | Hilaire et al. | Jan 2010 | B2 |
7651519 | Dittman | Jan 2010 | B2 |
7666219 | Rasmussen et al. | Feb 2010 | B2 |
7674284 | Melsheimer | Mar 2010 | B2 |
7678141 | Greenan et al. | Mar 2010 | B2 |
7691135 | Shaolian et al. | Apr 2010 | B2 |
7691139 | Baker et al. | Apr 2010 | B2 |
7695508 | Van Der Leest et al. | Apr 2010 | B2 |
7699885 | Leonhardt et al. | Apr 2010 | B2 |
7717923 | Kennedy, II et al. | May 2010 | B2 |
7722657 | Hartley | May 2010 | B2 |
7736337 | Diep et al. | Jun 2010 | B2 |
7736383 | Bressler et al. | Jun 2010 | B2 |
7736384 | Bressler et al. | Jun 2010 | B2 |
7753951 | Shaked et al. | Jul 2010 | B2 |
7758625 | Wu et al. | Jul 2010 | B2 |
7763063 | Arbefeuille et al. | Jul 2010 | B2 |
7766952 | Horan et al. | Aug 2010 | B2 |
7771463 | Ton et al. | Aug 2010 | B2 |
7785340 | Heidner et al. | Aug 2010 | B2 |
7785361 | Nikolchev et al. | Aug 2010 | B2 |
7794473 | Tessmer et al. | Sep 2010 | B2 |
7799266 | Parker et al. | Sep 2010 | B2 |
7833259 | Boatman | Nov 2010 | B2 |
7837724 | Keeble et al. | Nov 2010 | B2 |
7842066 | Gilson et al. | Nov 2010 | B2 |
7846135 | Runfola | Dec 2010 | B2 |
7867267 | Sullivan et al. | Jan 2011 | B2 |
7867270 | Hartley | Jan 2011 | B2 |
7871419 | Devellian et al. | Jan 2011 | B2 |
7871430 | Pavcnik et al. | Jan 2011 | B2 |
7879081 | DeMatteo et al. | Feb 2011 | B2 |
7883537 | Grayzel et al. | Feb 2011 | B2 |
7922755 | Acosta et al. | Apr 2011 | B2 |
7935140 | Griffin | May 2011 | B2 |
7942924 | Perez et al. | May 2011 | B1 |
8002814 | Kennedy, II et al. | Aug 2011 | B2 |
8021420 | Dolan | Sep 2011 | B2 |
8025692 | Feeser | Sep 2011 | B2 |
8034100 | Shaolian et al. | Oct 2011 | B2 |
8062344 | Dorn et al. | Nov 2011 | B2 |
8075607 | Melsheimer | Dec 2011 | B2 |
8075608 | Gordon et al. | Dec 2011 | B2 |
8092508 | Leynov et al. | Jan 2012 | B2 |
8167892 | Feller, III et al. | May 2012 | B2 |
8182522 | Sarac et al. | May 2012 | B2 |
8216295 | Bemjamin et al. | Jul 2012 | B2 |
8221494 | Schreck et al. | Jul 2012 | B2 |
8236040 | Mayberry et al. | Aug 2012 | B2 |
8357192 | Mayberry et al. | Jan 2013 | B2 |
8491646 | Schreck | Jul 2013 | B2 |
8523931 | Mayberry et al. | Sep 2013 | B2 |
8568466 | Shaolian et al. | Oct 2013 | B2 |
8808350 | Schreck et al. | Aug 2014 | B2 |
8821564 | Schreck et al. | Sep 2014 | B2 |
8844430 | Mastropasqua et al. | Sep 2014 | B2 |
8945202 | Mayberry et al. | Feb 2015 | B2 |
20050027305 | Shiu et al. | Feb 2005 | A1 |
20050038494 | Eidenschink | Feb 2005 | A1 |
20060229561 | Huszar | Oct 2006 | A1 |
20070168014 | Jimenez et al. | Jul 2007 | A1 |
20110009945 | Parker et al. | Jan 2011 | A1 |
20110015728 | Jimenez et al. | Jan 2011 | A1 |
20110046712 | Melsheimer et al. | Feb 2011 | A1 |
20110054586 | Mayberry et al. | Mar 2011 | A1 |
20110054587 | Mayberry et al. | Mar 2011 | A1 |
20110121023 | Milan | May 2011 | A1 |
20110178588 | Haselby | Jul 2011 | A1 |
20110218607 | Arbefeuille et al. | Sep 2011 | A1 |
20110218617 | Nguyen | Sep 2011 | A1 |
20110224742 | Weisel et al. | Sep 2011 | A1 |
20110224782 | Douglas et al. | Sep 2011 | A1 |
20110251664 | Acosta De Acevedo | Oct 2011 | A1 |
20110257718 | Argentine | Oct 2011 | A1 |
20110270371 | Argentine | Nov 2011 | A1 |
20110282425 | Dwork | Nov 2011 | A1 |
20110313503 | Berra et al. | Dec 2011 | A1 |
20120109279 | Mayberry | May 2012 | A1 |
20120277847 | Benjamen | Nov 2012 | A1 |
20130184805 | Sawada | Jul 2013 | A1 |
20140358214 | Schreck et al. | Dec 2014 | A1 |
Number | Date | Country |
---|---|---|
2220141 | Nov 1996 | CA |
2287406 | Dec 1997 | CA |
295 21 548 | Feb 1995 | DE |
295 21 776 | Feb 1995 | DE |
100 17 147 | Oct 2001 | DE |
0 177 330 | Jun 1991 | EP |
0 564 373 | Oct 1993 | EP |
0 596 145 | May 1994 | EP |
0 621 015 | Oct 1994 | EP |
0 659 389 | Jun 1995 | EP |
0 688 545 | Dec 1995 | EP |
0 689 806 | Jan 1996 | EP |
0 712 614 | May 1996 | EP |
0 732 088 | Sep 1996 | EP |
0 740 928 | Nov 1996 | EP |
0 740 928 | Nov 1996 | EP |
0 747 020 | Dec 1996 | EP |
0 775 470 | May 1997 | EP |
0 782 841 | Jul 1997 | EP |
0 783 873 | Jul 1997 | EP |
0 783 874 | Jul 1997 | EP |
0 875 262 | Nov 1998 | EP |
0 880 938 | Dec 1998 | EP |
0 880 948 | Dec 1998 | EP |
0 904 745 | Mar 1999 | EP |
0 974 314 | Jan 2000 | EP |
0 732 088 | Apr 2000 | EP |
1 358 903 | Nov 2003 | EP |
1 508 313 | Feb 2005 | EP |
2 680 915 | Jan 2014 | EP |
1 038 606 | Jul 1998 | ES |
1 193 759 | Jun 1970 | GB |
04-25755 | Jan 1992 | JP |
H05-81257 | Nov 1993 | JP |
H623057 | Feb 1994 | JP |
30-09638 | Apr 1994 | JP |
08-052165 | Feb 1996 | JP |
08-336597 | Dec 1996 | JP |
09-164209 | Jun 1997 | JP |
9-511160 | Nov 1997 | JP |
2000-500047 | Jan 2000 | JP |
2004-130068 | Apr 2004 | JP |
2010-536418 | Dec 2010 | JP |
WO 9014054 | Nov 1990 | WO |
WO 9313825 | Jul 1993 | WO |
WO 9424961 | Nov 1994 | WO |
WO 9521592 | Aug 1995 | WO |
WO 9614808 | May 1996 | WO |
WO 9634580 | Nov 1996 | WO |
WO 9639999 | Dec 1996 | WO |
WO 9641589 | Dec 1996 | WO |
WO 9710757 | Mar 1997 | WO |
WO 9710777 | Mar 1997 | WO |
WO 9714375 | Apr 1997 | WO |
WO 9717911 | May 1997 | WO |
WO 9719652 | Jun 1997 | WO |
WO 9726936 | Jul 1997 | WO |
WO 97033532 | Sep 1997 | WO |
WO 97045072 | Dec 1997 | WO |
WO 9802100 | Jan 1998 | WO |
WO 9853761 | Dec 1998 | WO |
WO-9904728 | Feb 1999 | WO |
WO 99029262 | Jun 1999 | WO |
WO 9944536 | Sep 1999 | WO |
WO 9947077 | Sep 1999 | WO |
WO 9958084 | Nov 1999 | WO |
WO 0078248 | Dec 2000 | WO |
WO 0236179 | May 2002 | WO |
WO 0239888 | May 2002 | WO |
WO 02060345 | Aug 2002 | WO |
WO 03068302 | Aug 2003 | WO |
WO 05037076 | Apr 2005 | WO |
WO 05037141 | Apr 2005 | WO |
WO 05067819 | Jul 2005 | WO |
WO 06071915 | Jul 2006 | WO |
WO 06117321 | Nov 2006 | WO |
WO 07027830 | Mar 2007 | WO |
WO 07092276 | Aug 2007 | WO |
WO 09023221 | Feb 2009 | WO |
WO-2010002931 | Jan 2010 | WO |
WO 11049808 | Apr 2011 | WO |
WO 12118901 | Sep 2012 | WO |
Entry |
---|
US 5,690,647 A, 11/1997, Osborne (withdrawn) |
US 6,413,270 B1, 07/2002, Thornton et al. (withdrawn) |
Chinese Office Action dated Dec. 10, 2014, from application No. 201280021287.5. |
Chinese Office Action dated Jun. 9, 2017, from application No. 201510649289.4. |
Chinese Office Action dated Nov. 16, 2017, from application No. 201510649289.4. |
Chinese Office Action dated Oct. 27, 2016, from application No. 201510649289.4. |
European Office Action dated Apr. 14, 2016, from application No. 12709432.4. |
Japanese Notice of Reasons for Refusal dated Jan. 7, 2016, from application No. 2013-556828. |
Japanese Notice of Reasons for Refusal dated Jul. 26, 2017, from application No. 2013-556828. |
Japanese Notice of Reasons for Refusal dated Sep. 8, 2016, from application No. 2013-556828. |
Notice of Allowance dated Apr. 14, 2014, from U.S. Appl. No. 13/408,952. |
Notice of Allowance dated Feb. 28, 2017, from U.S. Appl. No. 15/379,268. |
Notice of Allowance dated Sep. 21, 2016, from U.S. Appl. No. 14/462,485. |
European Office Action dated Aug. 21, 2018, from application No. 12709432.4. |
U.S. Appl. No. 15/639,028, filed Jun. 20, 2017, Benjamin et al. |
International Preliminary Report on Patentability, re PCT/US2012/027151, dated Sep. 12, 2013, in 8 pages. |
International Search Report and Written Opinion, re PCT/US2012/027151, dated Jun. 26, 2012. |
Number | Date | Country | |
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20170304098 A1 | Oct 2017 | US |
Number | Date | Country | |
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61448154 | Mar 2011 | US |
Number | Date | Country | |
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Parent | 13408952 | Feb 2012 | US |
Child | 14462485 | US |
Number | Date | Country | |
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Parent | 15379268 | Dec 2016 | US |
Child | 15632064 | US | |
Parent | 14462485 | Aug 2014 | US |
Child | 15379268 | US |