Delivering a uretheral stent

Information

  • Patent Grant
  • 6790223
  • Patent Number
    6,790,223
  • Date Filed
    Friday, September 21, 2001
    23 years ago
  • Date Issued
    Tuesday, September 14, 2004
    20 years ago
Abstract
A delivery system for placement of a stent within a body of a patient includes a stent, a retaining structure, and an elongated member. The stent includes a coil which defines a lumen and has an initial length when in an expanded rest state. Adjacent turns of the coil are positioned to substantially prevent tissue ingrowth through the turns and into the lumen when the stent is placed within the body. The retaining structure is sized for insertion into the body and includes one or more pins. The pins collapse and deform the stent while the stent maintains substantially its initial length. The elongated member is coupled to the retaining structure and enables insertion of the retaining structure with the stent into the body such that the stent can be deployed from the retaining structure and placed into the body while maintaining substantially its initial length.
Description




TECHNICAL FIELD




This invention generally relates to stents and delivery systems for inserting stents into the body of a patient.




BACKGROUND INFORMATION




The male urethra is generally a tubular passageway extending from the bladder to the end of the penis. As urine travels from the bladder and out of the body, the urine passes through four sections of the urethra, referred to as the prostatic urethra, the membranous urethra, the bulbar urethra, and the pendulous or distal urethra. Surrounding the prostatic urethra and below the bladder is a prostate gland, which, among other functions, produces the fluid in semen.




A urological condition that some, mostly male, patients experience is blockage of the urethra. For instance, prostate enlargement, also known as benign prostate hyperplasia (BPH), is a common affliction experienced by some men. The condition involves swelling of the prostate, which prevents passage of urine from the bladder and consequently makes urination difficult or impossible. Prostate cancer is another affliction suffered by some men and may lead to many of the same symptoms as BPH.




Medical devices, such as urethral stents, have been developed to correct the problems of urine flow. Urethral stents are designed to hold open one or more of the sections of the urethra obstructing the flow of urine. Generally, these stents are made from a relatively small diameter tube or coil of a biocompatible material such as plastic.




A delivery system is often employed to deliver a urethral stent into the body of the patient. To deliver a urethral coil stent into the body, an existing delivery system typically winds or tightens the coil stent onto the exterior of a delivering catheter to reduce the diameter of the coil stent. The length of the wound stent is greater than the length of the stent in its expanded rest state. That is, prior to winding the coil stent onto the catheter for delivery into the body, and after release of the coil stent in (or outside of) the body, the length of the coil stent is less than when it is wound down onto the exterior of the delivery catheter. The winding thus both reduces the diameter of and extends the length of the coil stent.




SUMMARY OF THE INVENTION




The reduction of length that occurs upon deployment of a urethral coil stent makes it difficult to position accurately the coil stent within the urethra. The invention involves allowing a physician or other medical practitioner or professional to deploy and position a coil stent in a patient's urethra without any substantial change in the length of the coil stent. Urethral coil stent delivery systems and related methods according to the invention allow accurate placement of the stent.




To avoid damaging surrounding structures (such as the external sphincter), a medical professional typically employs a scope (e.g., endoscope) to view the location at which the urethral coil stent will be placed. The medical professional can use the scope to line up the proximal end of the coil stent with the neck of the bladder. The length reduction that typically occurs when deploying a known urethral coil stent, however, frustrates the professional's ability to place accurately the stent even when a scope is used.




In one aspect, the invention generally relates to a delivery system for placement of a stent within the body of a patient. The stent includes a coil, an elongated member, and a retaining structure. The coil defines a lumen and has an initial length when the stent is resting in an expanded equilibrium, or rest, state. Additionally, adjacent turns of the coil are positioned to substantially prevent tissue ingrowth through the turns and into the lumen when the stent is placed within the body. The retaining structure collapses and deforms a portion of the stent. In particular, the retaining structure includes one or more pins which collapse and deform at least a portion of the stent at particular pressure points. The stent, however, substantially retains its initial length. The elongated member is coupled to a distal end of the retaining structure to enable insertion of the retaining structure with the collapsed and deformed stent into the body. This insertion enables the collapsed and deformed stent to be deployed from the retaining structure and placed into the body of the patient while maintaining substantially its initial length.




Embodiments of this aspect of the invention can include the following features. The delivery system can also include a sliding member that slides through a lumen defined by the elongated member. The sliding member exerts a deploying force on the stent to deploy the stent from the retaining structure. The delivery system can also include a handle coupled to the elongated member. The handle may also be coupled to the sliding member to allow an operator of the delivery system to use the handle to slide the sliding member through the lumen defined by the elongated member. This exerts the deploying force on the stent.




In another aspect, the invention includes a method of loading a stent into a retaining structure. The method includes providing a stent having a coil and having an initial length when in an expanded rest state. The method also includes providing a retaining structure sized for insertion into the body and having one or more pins. The method includes inserting the stent into the retaining structure so that at least a portion of the stent becomes collapsed and deformed by one or more pins while the stent retains its initial length.




The method may also include the step of providing the stent which includes a membrane coating the coil. In another embodiment, the method includes inserting the retaining structure with the collapsed and deformed stent into the body. This enables the deployment of the deformed and collapsed stent from the retaining structure and placed into the body of the patient while maintaining substantially its initial length. In a further embodiment, the method includes the step of sliding a sliding member through a lumen defined by the elongated member to deploy the collapsed and deformed stent into the body of the patient.




The directional terms proximal and distal require a point of reference. In this document, the point of reference in determining direction is from the perspective of a patient. The term “proximal” refers to a direction that points into the patient's body. The term “distal” refers to a direction that points out of the patient's body.




The foregoing and other objects, aspects, features, and advantages of the invention will become more apparent from the following description and from the claims.











BRIEF DESCRIPTION OF DRAWINGS




In the drawings, like reference characters generally refer to the same parts throughout the different views. Also, the drawings are not necessarily to scale, emphasis instead generally being placed upon illustrating the principles of the invention.





FIG. 1

is a schematic view of a male urinary system.





FIG. 2A

is an expanded side view of one embodiment of a urethral stent of the invention.





FIG. 2B

is a top view of the urethral stent from the perspective indicated by line


2


B—


2


B in FIG.


2


A.





FIG. 2C

is a side view of one embodiment of a single helix coil stent.





FIG. 2D

is a side view of one embodiment of a double helix coil stent.





FIG. 2E

is an expanded side view of another embodiment of a single helix coil stent.





FIG. 2F

is an expanded side view of another embodiment of a double helix coil stent.





FIG. 3A

is a side view of one embodiment of a distal portion of a stent delivery system according to the present invention.





FIG. 3B

is a perspective view of the proximal portion of the stent delivery system of

FIG. 3A

showing four pins.





FIG. 3C

is an end view of the stent delivery system from the perspective indicated by line


3


C—


3


C in FIG.


3


B and line


3


C—


3


C in FIG.


3


A.





FIG. 4A

is a side view of one embodiment of a urethral stent inserted into the stent delivery system shown in FIG.


3


A.





FIG. 4B

is an end view of the stent inserted into the stent delivery system from the perspective indicated by line


4


B—


4


B in FIG.


4


A.





FIG. 4C

is another end view of the stent inserted into the stent delivery system from the perspective indicated by line


4


B—


4


B in FIG.


4


A.





FIG. 5A

is a perspective view of the proximal portion of the stent delivery system of

FIG. 3A

showing three pins.





FIG. 5B

is an end view of the stent inserted into the stent delivery system from the perspective indicated by line


5


B—


5


B in FIG.


5


A.





FIG. 6A

is a perspective view of the proximal portion of the stent delivery system of

FIG. 3A

showing two pins.





FIG. 6B

is an end view of the stent inserted into the stent delivery system from the perspective indicated by line


6


B—


6


B in FIG.


6


A.





FIG. 6C

is an alternative end view of the stent inserted into the stent delivery system from the perspective indicated by line


6


B—


6


B in FIG.


6


A.





FIG. 7A

is a perspective view of the proximal portion of the stent delivery system of

FIG. 3A

showing one pin.





FIG. 7B

is another perspective view of the proximal portion of the stent delivery system of

FIG. 3A

showing one pin.





FIG. 7C

is an end view of the stent inserted into the stent delivery system from the perspective indicated by line


7


C—


7


C in FIG.


7


A.





FIG. 8

is a side view of a portion of the stent delivery system of FIG.


3


A.





FIG. 9A

is a perspective view of the proximal portion of the stent delivery system of

FIG. 3A

showing one pin and a sliding member.





FIG. 9B

is a perspective view of the proximal portion of the stent delivery system of

FIG. 3A

showing one pin and the sliding member of

FIG. 9A

extended.





FIG. 10

is a schematic view of a stent delivery system being inserted into a male patient's urinary system.





FIG. 11

is an expanded view of the stent delivery system of

FIG. 10

within the male patient's urinary system.





FIG. 12

is another expanded view of the stent delivery system of

FIG. 10

with the stent partially deployed within the male patient's urinary system.











DESCRIPTION




Urine retention and reduced urination are two common symptoms that some male patient afflicted with benign prostatic hyperplasia (BPH) endure. Benign prostatic hyperplasia is a medical condition in which a patient's prostate enlarges due to disease or a decrease in hormone production.

FIG. 1

shows a male urinary system


1


, which includes a bladder


2


, a urethra


3


, an external sphincter


4


, a meatus


5


, and a prostate


6


. The prostate


6


is a male reproductive organ that surrounds a section of the urethra


3


generally known as the prostatic urethra. Due to the prostate's location, the male urinary system


1


may be constricted and thus obstructed when the patient's prostate


6


enlarges.





FIG. 2A

illustrates an expanded side view of a urethral stent


100


to illustrate the components of the urethral stent


100


. The urethral stent


100


includes a coil segment


105


. The coil segment


105


defines a lumen extending within the urethral stent


100


that allows fluids, such as urine, to pass therethrough from the bladder


2


of a patient. When the urethral stent


100


is in a rest or unrestrained state in which no external or other forces are exerted upon any portion of the coil segment


105


, the coil segment


105


has an initial length


110


and the lumen defined by the coil segment


105


has an initial cross-sectional area


112


, as shown in FIG.


2


B. The coil segment


105


has adjacent turns


114


spaced close together to prevent tissue ingrowth. The adjacent turns


114


could touch each other, or could have some small spacing between them. Whatever the spacing or positioning of the adjacent turns


114


, it is sufficient to substantially prevent tissue ingrowth between adjacent turns and thus keep tissue from growing or impinging into the lumen defined by the coil segment


105


when the stent


100


is placed within the body of a patient. Although

FIG. 2A

illustrates significant spaces between the adjacent turns


114


,

FIG. 2A

exaggerates the distances between the adjacent turns


114


of the urethral stent


100


for illustrative purposes only.

FIGS. 2C and 2D

are more accurate with respect to the spacing/closeness of the adjacent turns


114


.




The coil segment


105


can be made from any biocompatible material that exhibits superelastic properties. Nickel-titanium, or nitinol, is preferable because of its superelastic or “pseudo-elastic” shape recovery properties. More specifically, these properties enable the coil segment


105


to withstand a significant amount of bending and flexing and deformation force(s), and yet return to its original and unrestrained state without becoming permanently deformed due to the force(s). Nitinol is an alloy that is characterized by its ability to be transformed from an austenitic crystal structure to a stress-induced martensitic structure at certain temperatures, and to return elastically to the austenitic shape when the stress is released. These alternating crystalline structures provide the alloy with its superelastic properties. Further, the concentration of the nickel with respect to the concentration of the titanium can be altered so long as the superelastic properties are present in the resulting coil segment


105


.




The material(s) from which the coil segment


105


is made do(es) not exhibit shape memory properties. For instance, the coil segment


105


does not utilize the reversion of nitinol to its austenite form (to recover the previous shape of the coil segment


105


) in response to raising the temperature of the coil segment


105


. In other embodiments, the coil segment


105


is made from a biocompatible polymer, such as polyethylene (PE) or polypropylene. Whatever materials are used to form the coil segment


105


, the coil segment


105


should exhibit superelastic properties in that the coil segment


105


should be able to undergo deforming force(s) and still be able to return to substantially its original, unrestrained state without any permanent deformation.




The thickness or diameter of the wire selected for the coil segment


105


influences the radial strength as well as the flexibility of the urethral stent


100


. The diameter (or, more generally, the cross-sectional shape) of the wire needs to be sufficiently large to assure that proper radial strength of the urethral stent


100


is achieved. Proper radial strength is typically required to prevent occlusion of the patient's prostatic urethra from the constriction created by the patient's enlarged prostate. At the same time, however, the diameter of the wire needs to be sufficiently thin to promote winding ease and flexibility of the urethral stent


100


to accommodate the patient's anatomy. The diameter of the wire used to form the coil segment


105


is generally in the range of from about 0.1 millimeters to about 3 millimeters thick. The wire is wound to form the coil segment


105


that includes a proximal portion


116


, a middle portion, and a distal portion


117


. Round wire can be used, but wire with another cross-sectional shape could instead be used, such as, for example, flat or rectangular, square, elliptical, etc.





FIGS. 2C and 2D

illustrate side views of two embodiments of the urethral coil stent


100


of FIG.


2


A. Urethral coil stent


118


is a single-helix coil stent and urethral coil stent


120


is a double-helix coil stent. The single-helix coil stent


118


is formed by bending a wire into a coil to form the coil segment


105


. The two ends of the wire in a single-helix coil stent


118


are on opposite sides of coil stent


118


. The double-helix coil stent


120


includes two parts of the wire for every turn of the coil segment


105


. Specifically, the double-helix coil stent


120


is formed by bending a wire into a coil and then turning one end of the wire around and tracing the coil in the reverse direction that was used to form the coil. Thus, upon completion of the double-helix coil stent


120


, the two ends of the wire used to form the double-helix coil stent


120


are located on one side of the double-helix coil stent


120


. Consequently, the double-helix coil stent


120


has a greater amount of support and rigidity relative to the single-helix coil stent


120


made from the same type of wire because the double-helix coil stent


120


has two portions of the wire for each turn of the coil segment


105


.




As shown with urethral coil stents


118


and


120


, substantially no spacing exists between adjacent turns


114


of the urethral coil stent. This prevents tissue ingrowth through the adjacent turns


114


and into the lumen defined by the urethral coil stent


118


,


120


, in accordance with the invention.




In another embodiment, the coil segment


105


of the urethral coil stent


100


is dipped in liquid silicone to coat the coil segment


105


with a webbing to prevent tissue ingrowth. Alternatively, the webbing, or “skin”, can be made from any flexible biocompatible polymer that can stretch when the coil segment


105


is extended lengthwise, collapse when the coil segment


105


is compressed lengthwise, and flex when the coil segment


105


is bent or deformed. However the webbing is applied to the coil segment


105


, the webbing could coat the exterior surface of the coil segment


105


, the interior surface of the coil segment


105


, or the exterior and interior surfaces of the coil segment


105


. For example, if the coil segment


105


is dipped in liquid silicone, the webbing may coat the exterior and interior surfaces of the coil segment


105


. Alternatively, the webbing may be applied or brushed onto the exterior surface or the interior surface of the coil segment


105


.





FIG. 2E

illustrates an expanded side view of a single-helix urethral coil stent


122


with a webbing


125


coating the exterior surface of the coil segment


105


of the urethral coil stent


122


. The webbing


125


surrounds the exterior of the adjacent turns


114


. The webbing


125


can be a solid, non-porous membrane that inhibits ingrowth of body tissue between the turns


114


of the coil segment


105


and prevents encrustation of the urethral coil stent


100


.

FIG. 2E

exaggerates the distance between adjacent turns


114


of the urethral coil stent


122


to better illustrate the webbing


125


surrounding the adjacent turns


114


.

FIG. 2F

illustrates an expanded side view of a double-helix urethral coil stent


128


with the webbing


125


surrounding the turns


114


of the double-helix coil stent


128


.

FIG. 2F

also exaggerates the distance between adjacent turns


114


of the double-helix urethral coil stent


128


to better illustrate the webbing


125


surrounding the adjacent turns


114


. Although

FIGS. 2E and 2F

show the webbing


125


coating the exterior of the turns


114


of the coil stent


122


,


128


, the webbing


125


could also coat the interior surface or the exterior and interior surfaces of the turns


114


of the coil stent


122


,


128


.




In one embodiment, to retain proper positioning of the urethral stent


100


within the patient's body and to inhibit movement of the positioned urethral stent


100


, the middle portion of the urethral stent


100


has a smaller diameter than the proximal portion


116


and the distal portion


117


of the urethral stent


100


. The middle portion, proximal portion


116


, and distal portion


117


can include any number of turns


114


of the coil segments


105


. The larger diameter of the distal portion


117


and the proximal portion


116


of the urethral stent


100


prevent the migration of the urethral stent


100


after insertion into the patient's urethra


3


. In particular, the greater diameter of the proximal portion


116


prevents the distal migration of the urethral stent


100


(down and out of the bladder opening); whereas, the greater diameter of the distal portion


117


prevents the proximal migration of the urethral stent


100


(up into the bladder


2


of the patient).




Referring to

FIG. 3A

, an embodiment of a stent delivery system


200


according to the invention includes a retaining structure


205


and an elongated member


208


. The delivery system


200


enables a urethral coil stent


100


to be collapsed and deformed upon insertion into the retaining structure


205


while the length of the collapsed and deformed urethral coil stent


100


remains the same as the initial length


110


of the urethral coil stent


100


when in its rest state. The multiple forces exerted by the retaining structure


205


on one or more portions of the urethral coil stent


100


causes the urethral coil stent


100


to maintain its initial length. Upon deployment of the urethral coil stent


100


from the stent delivery system


200


, the cross-sectional area of the lumen defined by the urethral coil stent


100


expands and the length of the deployed urethral coil stent


100


remains at its initial length


110


, thereby eliminating the typical shortening of a urethral coil stent upon deployment into the body of the patient. In one embodiment, the cross-sectional area of the lumen defined by the urethral coil stent


100


expands to substantially its initial cross-sectional area


112


. In another embodiment, the urethral coil stent


100


does not expand to its initial cross-sectional area


112


because the urethra


3


blocks an expansion to the initial cross-sectional area


112


.




In one embodiment, the retaining structure


205


includes several pins


212


to deform the urethral stent


100


upon insertion into the retaining structure


205


. The pins


212


can have any size and shape so long as the pins


212


deform the urethral stent


100


so that the cross-sectional area of the lumen defined by the urethral stent


100


is reduced relative to the initial cross-sectional area


112


of the lumen defined by the urethral stent


100


when the urethral stent


100


is in its expanded rest state. As discussed in more detail below, the retaining structure


205


may have any number of pins to deform a urethral stent


100


. The retaining structure


205


holds the urethral stent


100


and deforms a portion of or the entire urethral stent


100


while maintaining the initial length


110


of the urethral coil stent


100


. The deformation is applied at particular pressure points, and in the disclosed embodiment along the entire length of the stent


100


. More particularly, the deformation causes one portion of the urethral coil stent


100


to fold inward on the urethral stent


100


. Without a physical deformation of the urethral stent


100


, the urethral stent


100


would not be able to fit inside the retaining structure


205


.




The elongated member


208


is coupled to the distal end of the retaining structure


205


to enable insertion of the retaining structure


205


with the collapsed and deformed urethral stent


100


while the stent


100


maintains substantially its initial length. The elongated member


208


also defines a lumen


216


.




The stent delivery system


200


also includes a coupling piece


220


that couples the retaining structure


205


to the elongated member


208


. In one embodiment, the lumen


216


of the elongated member


208


has a smaller cross-sectional area than the cross-sectional area of the coupling piece


220


. The coupling piece


220


can have any shape (e.g., spherical, rectangular). For example, the coupling piece


220


can be rectangular to sharply transition between the elongated member


208


and the retaining structure


205


. Alternatively, the coupling piece


220


can have a conical shape


228


to gradually transition between the elongated member


208


and the retaining structure


205


.





FIG. 3B

illustrates a perspective view of the proximal portion of the stent delivery system


200


of

FIG. 3A

showing four pins


212


. The four pins


212


collapse and deform a urethral stent


100


that is inserted into the retaining structure


205


. Additionally, the stent delivery system


200


shown in

FIG. 3B

includes a cylindrical coupling piece


220


. Moreover,

FIG. 3C

is an end view of the stent delivery system


200


from the perspective indicated by line


3


C-


3


C in FIG.


3


B and line


3


C-


3


C in FIG.


3


A.




Referring to

FIG. 4A

, the urethral stent


100


is inserted into the retaining structure


205


of the stent delivery system


200


. Upon inserting the urethral stent


100


into the retaining structure


205


, the four pins


212


of the retaining structure


205


collapse and deform the urethral stent


100


. The cross-sectional area of the urethral stent


100


is reduced while the urethral stent


100


maintains its initial length


110


. Looking along line


4


B—


4


B of

FIG. 4A

, an end view of the inserted urethral stent


100


is shown in FIG.


4


B. The urethral stent


100


that has been inserted into the retaining structure


205


is deformed by the four pins


212


at particular pressure points to produce four lobes


232


in the urethral stent


100


.




More specifically, each pin


212


deforms the urethral stent


100


at a particular pressure point to produce a lobe


232


. A pressure point can be any point on the coil segment


105


. An exemplary pressure point (after the deformation of the coil segment


105


) is illustrated as pressure point


230


at the bottom of the lobe


232


. Thus, as shown in

FIG. 4B

, a pin


212


produces a lobe


232


by deforming the urethral stent


100


and, as a consequence of the deformation, two crests


231


,


233


are formed. The pair of crests


231


,


233


surround the lobe


232


and, more specifically, are produced as a result of the deforming force applied by a pin


212


at the particular pressure point


230


. Therefore, a retaining structure


205


having four pins


212


, for example, produces four lobes (e.g., lobe


232


) at particular pressure points at which the pins


212


deform the urethral stent


100


. Moreover, this deformation results in the production of four crests (e.g., crests


231


,


233


) with a crest on each side of each lobe (e.g., lobe


232


).




Furthermore and also referring to

FIG. 4C

, if a pin


212


exerts a deforming force that greatly deforms the urethral stent


100


so that the bottom of a lobe


232


extends past the center


234


of the lumen defined by the urethral stent


100


(when viewing an end view of the coil segment


105


), the two surrounding crests


231


,


233


exhibit greater deformation and can begin to bend towards each other. Particularly, the distance


235


between the two crests


231


,


233


begins to diminish as the deformation force exerted by the pin


212


at the pressure point


230


increases. Moreover, as a pin


212


exerts a larger deformation force at the particular pressure point


230


, the depth of the resulting lobe


232


also increases.




The superelastic properties of the material used to construct the coil segment


105


enable the cross-sectional area of the lumen defined by the coil segment


105


to expand to substantially its initial cross-sectional area


112


upon deployment of the urethral stent


100


(into the urethra of a patient, for example). More specifically, when the pins


212


of the retaining structure


205


lose contact with the coil segment


105


, the coil segment


105


expands to substantially its initial cross-sectional area


112


in its rest state (unless the coil segment


105


is blocked by the urethra


3


). During and after this expansion, however, the length of the coil segment


105


remains at the initial length


110


. Thus, the deformation of the urethral coil stent


100


enables the length of the urethral coil stent


100


to maintain substantially the same length. Conversely, the length of the coil segment


105


would not remain static if the urethral coil stent


100


was wound or tightened onto the exterior of a delivering catheter.




When the coil segment


105


is released into and placed within the urethra of a patient, the surrounding urethra typically acts as a wall and a restraining force which may not allow the coil segment


105


to return fully to its rest or unrestrained state with the initial cross-sectional area


112


, but in general the coil segment


105


has enough radial opening force to return substantially to its original, unrestrained form and thereby keep the urethra open.




In another embodiment and referring to

FIG. 5A

, a retaining structure


236


of the delivery system


200


has three pins


212


.

FIG. 5B

shows an end view of the stent inserted into the stent delivery system


200


from the perspective indicated by line


5


B—


5


B in FIG.


5


A. The three pins


212


produce a deformed urethral coil stent


100


having three lobes


232


upon insertion of the urethral stent


100


into the retaining structure


236


. The pins


212


support and secure the urethral coil stent


100


while collapsing and deforming the urethral stent


100


. In particular, each pin


212


of the retaining structure


236


collapses the portion of the urethral coil stent


100


that contacts the pin


212


. While in the deformed state, the urethral coil stent


100


retains its initial length


110


.




Referring to

FIG. 6A

, a retaining structure


240


of the stent delivery system


200


has two pins


212


. In one embodiment, the two pins


212


of the retaining structure


240


secure and simultaneously collapse and deform the urethral coil stent


100


. The two pins


212


are parallel to each other and on the same vertical plane. The retaining structure


240


may also include a securing piece (not shown) in addition to the pins


212


. As shown in more detail with respect to

FIG. 7A

, the securing piece would provide additional support and an additional securing device for securing the urethral coil stent


100


. The securing piece would not substantially deform the urethral coil stent


100


in any manner.





FIGS. 6B and 6C

show end views of the urethral coil stent


100


inserted into the stent delivery system


200


from the perspective indicated by line


6


B—


6


B in FIG.


6


A. Two lobes


232


are produced from the collapsing and deforming of the urethral coil stent


100


by the retaining structure


240


having two pins


212


. The two pins


212


can alternatively have any other configuration as long as the two pins


212


can secure, collapse, and deform the urethral coil stent


100


while enabling the urethral coil stent


100


to retain its initial length


110


.

FIG. 6C

, for example, illustrates another embodiment of an end view of the urethral coil stent


100


that is inserted into the stent delivery system


200


having a retaining structure


240


with the two pins


212


positioned in different vertical planes. Other embodiments of the retaining structure


240


having two pins


212


can be used to produce many variations on the configuration of the lobes


232


of the urethral coil stent


100


.





FIG. 7A

shows a perspective view of the proximal portion of the stent delivery system


200


having a retaining structure


244


with one pin


212


. When having one pin


212


, the retaining structure


244


has a securing piece


248


that helps secure an inserted urethral coil stent


100


without deforming the urethral coil stent


100


. The securing piece


248


can be an extension of the coupling piece


220


. For example, the securing piece


248


can be a cylindrical structure (as shown in FIG.


7


A). Alternatively and as shown in

FIG. 7B

, a securing piece


250


can be an extension of a portion of the coupling piece


220


, such as a curved planar structure, that provides support to and does not deform the inserted urethral coil stent


100


.




Either of these examples of the retaining structure


244


having a securing piece


248


produces a urethral coil stent


100


having one lobe


212


, as shown in

FIG. 7C

from the perspective indicated by line


7


C—


7


C in FIG.


7


A.




To deploy the urethral coil stent


100


into the body of the patient, a deploying force is exerted on the distal portion


117


of the retained urethral coil stent


100


(i.e., the end closest to the coupling piece


220


). The deploying force pushes the collapsed and deformed urethral coil stent


100


out of the retaining structure


205


. As shown in

FIG. 8

, the distal portion of the stent delivery system


200


includes a sliding member


252


to exert the deploying force described above on the urethral coil stent


100


(not shown) inserted into the retaining structure


205


(not shown). The distal end


254


of the stent delivery system


200


includes a handle


256


that enables the sliding member


252


to slide along a body


268


of the stent delivery system


200


. In particular, the handle


256


is coupled to the elongated member


208


and the sliding member


252


. The medical professional using the stent delivery system


200


causes the handle


256


to slide the sliding member


252


through the lumen defined by the elongated member


208


to exert the deploying force on the urethral stent


100


to deploy the stent


100


from the retaining structure


205


. In even more detail, the medical professional causes the sliding member


252


to slide towards the coupling piece


220


by pulling an inside handle arm


260


towards an outside handle arm


264


(shown by arrow


270


).




The handle


256


may include a spring (not shown) attached from the distal end


254


of the stent delivery system


200


to the distal end


272


of the sliding member


252


. The handle


256


includes the spring so that the movement of the inside handle arm


260


towards the outside handle arm


264


compresses the spring. Upon release of the handle arms


260


,


264


, the spring subsequently expands longitudinally to provide an actuation force on the sliding member


252


. The actuation force produces movement of the sliding member


252


along line


274


so that the sliding member


252


can exert the deploying force on the urethral stent


100


. Any other means can also be used to provide an actuation force on and subsequent movement of the sliding member


252


.




As shown in

FIG. 9A

, the sliding member


252


includes a deploying mechanism


278


attached to its proximal end


280


to ensure that the sliding member


252


provides the deploying force on the urethral coil stent


100


(not shown). Without the deploying mechanism


278


, the sliding member


252


may slide through the lumen defined by the urethral coil stent


100


without colliding with the urethral coil stent


100


. The deploying mechanism


278


is a circular shaped member in which a portion contacts the urethral coil stent


100


as a result of the movement


274


of the sliding member


252


from the actuation force. Alternatively, the deploying mechanism


278


can be any shaped mechanism, such as a square, octagonal, and triangular, so long as the sliding member


252


provides some sort of deploying force on the urethral coil stent


100


to deploy the urethral coil stent


100


from the retaining structure


205


.




Upon application of the actuation force


274


shown in

FIG. 9B

, the sliding member


252


slides the deploying mechanism


278


towards the distal portion


117


of the urethral coil stent


100


. The sliding member


252


deploys the urethral coil stent


100


by pushing the urethral coil stent


100


out of the retaining structure


205


with the deploying mechanism


278


. Although

FIGS. 9A and 9B

show the retaining structure


205


without a securing piece


248


,


250


and with one pin


212


, it is for illustrative purposes only. Additionally, the retaining structure


205


can have any number of pins with the sliding member


252


and the deploying mechanism


278


.




Referring to

FIG. 10

, a medical professional inserts the delivery system


200


into the meatus


5


of the patient. In one embodiment, the medical professional uses the handle


256


to insert the delivery system


200


into the meatus


5


. The medical professional advances the urethral stent


100


and the delivery system


200


through the patient's urinary system


1


until the urethral stent


100


is located substantially within the prostatic urethra


3


with the proximal portion


116


located near the opening of the patient's bladder


2


and the distal portion


117


terminating prior to the proximal side of the patient's external sphincter


4


so as not to interfere with the normal operation of the external sphincter


4


. In particular, the elongated member


208


guides the urethral stent


100


grasped by the retaining structure


205


into the urethra


3


and into the area in which the urethra


3


is occluded by the enlarged prostate


6


. In one embodiment, the retaining structure


205


and/or the elongated member


208


are flexible and one or both bend to follow the curvature of the urethra


3


as they are inserted into the body of the patient.





FIGS. 11 and 12

are expanded views of the stent delivery system


200


within the male patient's urinary system


1


as shown in FIG.


10


. The retaining structure


205


holds the urethral stent


100


with the pins


212


. In the embodiment shown, the urethral stent


100


is encapsulated by the webbing


125


to prevent tissue ingrowth. The medical professional inserts the stent delivery system


200


into the urethra


3


until reaching the occluded portion of the urethra


3


. In one embodiment, the medical professional uses an endoscope to determine when the stent delivery system


200


reaches the occluded portion. As described previously, the urethral stent


100


maintains its initial length


110


during the insertion, positioning, and deployment of the stent delivery system


200


. The medical professional then uses the handle


256


to deploy the urethral stent


100


by exerting the actuation force


274


(not shown) onto the sliding member


252


, thereby deploying the urethral stent


100


by exerting the deploying force on the stent


100


.




The urethral stent


100


radially expands upon deployment from the retaining structure to prop open the occluded urethra


3


, while allowing the patient to control the opening and closing of his external sphincter


4


because that section of the urethra is not propped open by the stent


100


. The radial expansion of the urethral stent


100


occurs without any substantial change in the length of the urethral coil stent


100


, in accordance with the invention. Because the stent


100


retains its initial length


110


, the medical professional can place the stent


100


with great accuracy. The stent


100


will not expand longitudinally into sections of the urethra not intended to be propped open.




At some later time, the medical professional can remove the urethral stent


100


by using a grasping device, such as forceps, to engage and remove the urethral stent


100


from the body of the patient.




Variations, modifications, and other implementations of what is described herein will occur to those of ordinary skill in the art without departing from the spirit and the scope of the invention. The invention is not to be limited only to the preceding illustrative description.



Claims
  • 1. A delivery system for placement of a stent within a body of a patient, comprising:(a) a stent comprising a coil defining a lumen and having an initial length when in an expanded rest state, adjacent turns of the coil being positioned to substantially prevent tissue ingrowth through the turns and into the lumen when the stent is placed within the body; (b) a retaining structure sized for insertion into the body and comprising one or more pins which collapse and deform at least a portion of the stent, thereby altering the cross-sectional shape of the stent, while the stent maintains substantially its initial length; and (c) an elongated member coupled to a distal end of the retaining structure to enable insertion of the retaining structure with the collapsed and deformed stent into the body such that the collapsed and deformed stent can be deployed from the retaining structure and placed into the body of the patient while maintaining substantially its initial length.
  • 2. The delivery system of claim 1 further comprising a sliding member that slides through a lumen defined by the elongated member to exert a deploying force on the stent to deploy the stent from the retaining structure.
  • 3. The delivery system of claim 2 further comprising a handle coupled to the elongated member.
  • 4. The delivery system of claim 3 wherein the handle is also coupled to the sliding member to allow an operator to use the handle to slide the sliding member through the lumen defined by the elongated member and thereby exert the deploying force on the stent.
  • 5. The delivery system of claim 1 wherein the coil comprises a superelastic material.
  • 6. The delivery system of claim 1 wherein the coil comprises a material acceptable to the body of the patient.
  • 7. The delivery system of claim 6 wherein the material comprises an alloy of nickel-titanium or a plastic.
  • 8. The delivery system of claim 1 wherein the stent comprises a membrane coating the coil.
  • 9. The delivery system of claim 1 further comprising a coupling piece for coupling the elongated member to the retaining structure.
  • 10. The delivery system of claim 9 wherein a lumen defined by the elongated member has a smaller cross-sectional area than the cross-sectional area of the coupling piece.
  • 11. A method of loading a stent into a retaining structure, comprising:(a) providing a stent comprising a coil defining a lumen and having an initial length when in an expanded rest state, adjacent turns of the coil being positioned to substantially prevent tissue ingrowth through the turns and into the lumen when the stent is placed within a body of a patient; (b) providing a retaining structure sized for insertion into the body and comprising one or more pins; and (c) inserting the stent into the retaining structure such that at least a portion of the stent becomes collapsed and deformed by the one or more pins, thereby altering the cross-sectional shape of the stent, while the stent retains its initial length.
  • 12. The method of claim 11 wherein the step of providing the stent comprises providing the stent which includes a membrane coating the coil.
  • 13. The method of claim 11 wherein the step of providing the stent comprises providing the stent which includes a silicone coating formed by dipping the coil in liquid silicone.
  • 14. The method of claim 11 further comprising providing an elongated member coupled to a distal end of the retaining structure.
  • 15. The method of claim 14 further comprising inserting the retaining structure with the collapsed and deformed stent into the body such that the collapsed and deformed stent can be deployed from the retaining structure and placed into the body of the patient while maintaining substantially its initial length.
  • 16. The method of claim 15 further comprising sliding a sliding member through a lumen defined by the elongated member.
  • 17. The method of claim 16 further comprising exerting an actuation force on the sliding member to cause the sliding member to slide through the lumen defined by the elongated member and exert a deploying force on the stent.
  • 18. A delivery system for placement of a stent within a body of a patient, comprising:(a) means for retaining at least a portion of a stent in a collapsed and deformed state with one or more pins, thereby altering the cross-sectional shape of the stent, while the collapsed and deformed stent maintains substantially an initial length, the stent having the initial length when in an expanded rest state, the stent comprising a coil defining a lumen, adjacent turns of the coil being positioned to substantially prevent tissue ingrowth through the turns and into the lumen when the stent is placed within the body; and (b) means, coupled to the retaining means, for enabling insertion of the retaining means with the collapsed and deformed stent into the body such that the collapsed and deformed stent can be deployed from the retaining means and placed into the body of the patient while maintaining substantially its initial length.
  • 19. The delivery system of claim 18 further comprising means for exerting a deploying force on the stent to deploy the stent from the retaining means.
  • 20. The delivery system of claim 18 further comprising means for coating the coil with a membrane.
US Referenced Citations (137)
Number Name Date Kind
3527226 Hakim et al. Sep 1970 A
3657744 Ersek Apr 1972 A
3938529 Gibbons Feb 1976 A
4156067 Gould May 1979 A
4240434 Newkirk Dec 1980 A
4423725 Baran et al. Jan 1984 A
4660560 Klein Apr 1987 A
4768507 Fischell et al. Sep 1988 A
4771773 Kropf Sep 1988 A
4895566 Lee Jan 1990 A
4932938 Goldberg et al. Jun 1990 A
4973301 Nissenkorn Nov 1990 A
4990155 Wilkoff Feb 1991 A
4994066 Voss Feb 1991 A
5037427 Harada et al. Aug 1991 A
5041092 Barwick Aug 1991 A
5059169 Zilber Oct 1991 A
5061275 Wallsten et al. Oct 1991 A
5078720 Burton et al. Jan 1992 A
5122154 Rhodes Jun 1992 A
5147370 McNamara et al. Sep 1992 A
5160341 Brenneman et al. Nov 1992 A
5167614 Tessmann et al. Dec 1992 A
5176625 Brisson Jan 1993 A
5176626 Soehendra Jan 1993 A
5183085 Timmermans Feb 1993 A
5195989 Euteneuer Mar 1993 A
5222971 Willard et al. Jun 1993 A
5224953 Morgentaler Jul 1993 A
5234456 Silvestrini Aug 1993 A
5258020 Froix Nov 1993 A
5269802 Garber Dec 1993 A
5282784 Willard Feb 1994 A
5282823 Schwartz et al. Feb 1994 A
5286254 Shapland et al. Feb 1994 A
5292315 Euteneuer Mar 1994 A
5304121 Sahatjian Apr 1994 A
5316016 Adams et al. May 1994 A
5322501 Mahmud-Durrani Jun 1994 A
5342348 Kaplan Aug 1994 A
5344395 Whalen et al. Sep 1994 A
5356423 Tihon et al. Oct 1994 A
5419760 Narciso, Jr. May 1995 A
5421955 Lau et al. Jun 1995 A
5429634 Narciso, Jr. Jul 1995 A
5441515 Khosravi et al. Aug 1995 A
5441516 Wang et al. Aug 1995 A
5464650 Berg et al. Nov 1995 A
5496277 Termin et al. Mar 1996 A
5499994 Tihon et al. Mar 1996 A
5514176 Bosley, Jr. May 1996 A
5514669 Selman May 1996 A
5536242 Willard et al. Jul 1996 A
5545208 Wolff et al. Aug 1996 A
5549559 Eshel Aug 1996 A
5554181 Das Sep 1996 A
5556413 Lam Sep 1996 A
5562622 Tihon Oct 1996 A
5584872 LaFontaine et al. Dec 1996 A
5588965 Burton et al. Dec 1996 A
5593403 Buscemi Jan 1997 A
5599306 Klein et al. Feb 1997 A
5601591 Edwards et al. Feb 1997 A
5609629 Fearnot et al. Mar 1997 A
5618299 Khosravi et al. Apr 1997 A
5626562 Castro May 1997 A
5667486 Mikulich et al. Sep 1997 A
5667490 Keith et al. Sep 1997 A
5676693 LaFontaine Oct 1997 A
5702361 Evans et al. Dec 1997 A
5702419 Berry et al. Dec 1997 A
5723003 Winston et al. Mar 1998 A
5725549 Lam Mar 1998 A
5733303 Israel et al. Mar 1998 A
5738654 Tihon Apr 1998 A
5766209 Devonec Jun 1998 A
5766238 Lau et al. Jun 1998 A
5772668 Summers et al. Jun 1998 A
5776142 Gunderson Jul 1998 A
5782838 Beyar et al. Jul 1998 A
5797952 Klein Aug 1998 A
5824037 Fogarty et al. Oct 1998 A
5824038 Wall Oct 1998 A
5830179 Mikus et al. Nov 1998 A
5833707 McIntyre et al. Nov 1998 A
5843103 Wulfman Dec 1998 A
5876445 Andersen et al. Mar 1999 A
5888201 Stinson et al. Mar 1999 A
5902328 LaFontaine et al. May 1999 A
5911752 Dustrude et al. Jun 1999 A
5916227 Keith et al. Jun 1999 A
5928217 Mikus et al. Jul 1999 A
5938670 Keith et al. Aug 1999 A
5957929 Brenneman Sep 1999 A
5964732 Willard Oct 1999 A
5964744 Balbierz et al. Oct 1999 A
5976165 Ball Nov 1999 A
5980550 Eder et al. Nov 1999 A
6001117 Huxel et al. Dec 1999 A
6004328 Solar Dec 1999 A
6017977 Evans et al. Jan 2000 A
6019779 Thorud et al. Feb 2000 A
6023638 Swanson Feb 2000 A
6024763 Lenker et al. Feb 2000 A
6033413 Mikus et al. Mar 2000 A
6042606 Frantzen Mar 2000 A
6047218 Whayne et al. Apr 2000 A
6050949 White et al. Apr 2000 A
6066167 Lau et al. May 2000 A
6066168 Lau et al. May 2000 A
6090103 Hakky et al. Jul 2000 A
6090115 Beyar et al. Jul 2000 A
6113594 Savage Sep 2000 A
6113597 Eggers et al. Sep 2000 A
6119697 Engel et al. Sep 2000 A
6126667 Barry et al. Oct 2000 A
6132460 Thompson Oct 2000 A
6132461 Thompson Oct 2000 A
6139536 Mikus et al. Oct 2000 A
6146416 Andersen et al. Nov 2000 A
6152919 Hakky Nov 2000 A
6156064 Chouinard Dec 2000 A
6162215 Feng Dec 2000 A
6162231 Mikus et al. Dec 2000 A
6165210 Lau et al. Dec 2000 A
6174305 Mikus et al. Jan 2001 B1
6176875 Lenker et al. Jan 2001 B1
6179868 Burpee et al. Jan 2001 B1
6187015 Brenneman Feb 2001 B1
6214037 Mitchell et al. Apr 2001 B1
6221081 Mikus et al. Apr 2001 B1
6238430 Klumb et al. May 2001 B1
6254628 Wallace et al. Jul 2001 B1
6334866 Wall Jan 2002 B1
6355061 Quiachon et al. Mar 2002 B1
6371979 Beyar et al. Apr 2002 B1
20020107540 Whalen et al. Aug 2002 A1
Foreign Referenced Citations (19)
Number Date Country
0 274 846 Jul 1988 EP
0 341 988 Nov 1989 EP
WO 8001460 Jul 1980 WO
WO 8903232 Apr 1989 WO
WO 9116005 Oct 1991 WO
WO 9623449 Aug 1996 WO
WO 0015130 Mar 2000 WO
WO 0016005 Mar 2000 WO
WO 0018907 Apr 2000 WO
WO 0019926 Apr 2000 WO
WO 0021462 Apr 2000 WO
WO 0051521 Sep 2000 WO
WO 0056247 Sep 2000 WO
WO 0059558 Oct 2000 WO
WO 0069367 Nov 2000 WO
WO 0069498 Nov 2000 WO
WO 0076425 Dec 2000 WO
WO 0110345 Feb 2001 WO
WO 0205841 Aug 2002 WO
Non-Patent Literature Citations (1)
Entry
Patent Cooperation Treaty, International Search Report, International Application No. PCT/US 02/29537, mailed on Mar. 26, 2003, 6 pages.