Method of stenting with minimal diameter guided delivery systems

Abstract

Medical devices and methods for delivery or implantation of prostheses within hollow body organs and vessels or other luminal anatomy are disclosed. The subject technologies may be used in the treatment of atherosclerosis in stenting procedures or be used in a variety of other procedures.

Description

BRIEF DESCRIPTIONS OF THE DRAWINGS

The figures provided herein are not necessarily drawn to scale, with some components and features being exaggerated for clarity. Each of the figures diagrammatically illustrates aspects of the invention. Of these:

FIG. 1 shows a heart in which its vessels may be the subject of one or more angioplasty and stenting procedures;

FIGS. 2A and 2B show a first expanded stent cut pattern and an expanded view of a section of the same, respectively;

FIGS. 2C and 2D show a second expanded stent cut pattern and an expanded view of a section of the same, respectively;

FIGS. 3A-3E show a portion of a stent as described in FIGS. 2A-2D, illustrating aspects of stent compression;

FIGS. 4A-4H show stent deployment hardware and methodology for carrying out an angioplasty and stenting procedure;

FIG. 5 shows an overview of a delivery system according to the present invention;

FIGS. 6A and 6B are partial cross-sectional illustrations of variations of working ends of delivery systems with mandrels placed within stents according to the present invention;

FIG. 7 is a partial cross-sectional view with a distal end of the stent wedged open by an introducer;

FIG. 8A is a partial cross-sectional view with a distal end of the stent wedged open by end features on the stent; FIG. 8B shows the end of the stent taken along line 8B-8B in FIG. 8A; and FIG. 8C shows a plan view of a wedge feature for either end of a stent for maintaining an opening when the stent is in a compressed state;

FIG. 9 is a partial cross-sectional view of a variation of the invention where the mandrel portions holding open the stent comprises part of a guidewire;

FIG. 10 is a partial cross-sectional view of a variation of the invention where the mandrel portions holding open the stent comprises a guidewire extension;

FIG. 11 is a partial cross-sectional view of a variation of the invention where the mandrel/guidewire may be converted to a pusher for delivering the stent;

FIG. 12 is a partial cross-sectional view of a rapid-exchange variation of the present invention; and

FIG. 13 is a final partial cross-sectional view of a variation of the present invention in which the delivery system is sized for use within such a balloon catheter body as optionally employed in other variations of the invention.

Claims

1. A method for stenting a body passageway, the method comprising: locating a distal end of a guidewire at a site within the body passageway;feeding a delivery catheter over the guidewire, wherein a catheter body includes a lumen and a superelastic stent slidably compressed in the lumen, and a means to maintain at least a far end of the stent in an open configuration; anddeploying the stent by withdrawing the catheter body while the stent position is maintained by a blocker.

2. The method of claim 1, wherein the site is within a coronary artery selected from the group of small diagonals, PDA, and OM vessels.

3. The method of claim 2, wherein a diameter at the site is between about 2 mm and about 3 mm.

4. The method of claim 1, wherein the guidewire is a 0.014 inch guidewire

5. The method of claim 1, wherein the delivery catheter includes an angioplasty balloon and an inflation lumen, the method further comprising dilatating the balloon.

6. The method of claim 1, wherein the means comprises abutting ends of the stent.

7. The method of claim 1, wherein the means comprises a mandrel extending through at least a portion of the stent and the method further comprises pushing the mandrel from the delivery catheter lumen by feeding the delivery catheter over the guidewire.

8. The method of claim 7, wherein the mandrel extends through the length of the catheter body.

9. The method of claim 7, wherein the mandrel is a guidewire.

10. The method of claim 9, wherein the delivery system is about 190 cm long and the guidewire is longer.

11. The method of claim 10, wherein the guidewire is an exchange-length guidewire.

12. The method of claim 11, wherein a proximal side of the guidewire is adapted to dock with an extension wire.

13. The method of claim 9, wherein the mandrel comprises an extension wire including a distal end adapted to dock with the guidewire.

14. The method of claim 1, wherein a distal end of the blocker is adapted to hold open a proximal end of the stent.

15. The method of claim 1, wherein the blocker comprises an end of a tubular slider, and the method further comprise stabilizing the slider at a proximal end with a pusher when withdrawing the delivery catheter body.

16. The method of claim 1, wherein the blocker comprises an end of an elongate member actuatable from a proximal end of the delivery catheter.

17. The method of claim 16, wherein the elongate member is tubular and the guidewire remains in the delivery guide lumen during stent delivery.

18. The method of claim 16, wherein the elongate member is solid and the method further comprises exchanging the guidewire for the elongate member.

19. The method of claim 1, wherein the delivery catheter is fed in an over-the-wire fashion.

20. The method of claim 1, wherein the delivery catheter is fed in a rapid-exchange fashion.

21. The method of claim 1, wherein the guidewire is an 0.014 inch size guidewire.

22. The method of claim 1, wherein the guidewire is an 0.010 inch size guidewire.