The present invention relates to the delivery of stents. A stent is a type of endoprosthesis device, typically intraluminally placed or implanted within a vein, artery, or other tubular body organ for treating an occlusion, stenosis, aneurysm, collapse, dissection, or weakened, diseased, or abnormally dilated vessel or vessel wall, by expanding the vessel or by reinforcing the vessel wall. In particular, stents are quite commonly implanted into the coronary, pulmonary, neurovascular, peripheral vascular, renal, gastrointestinal and reproductive systems, in order to reinforce individual body organs. The invention described herein is particularly useful for deploying stents in bifurcations, and is therefore described below with respect to this application.
In vessel bifurcations, a main vessel splits into two branch vessels. Implanting stents in bifurcations is particularly problematic because of the need to precisely locate the stent both longitudinally and radially in the bifurcation. This is especially the case when the stent is designed with a side opening which is to face the ostium of the branching vessel. One technique for precisely locating the stent is by initially introducing two guidewires into the main vessel, one guidewire extending through the bifurcation into one branch vessel, and the other guidewire extending through the bifurcation into the other branch vessel, and then using the two guidewires for guiding the stent, which is mounted on a delivery device, e.g., a balloon angioplasty catheter, to its precise longitudinal position and radial orientation before deploying the stent. One such technique involving the initial placement of two guidewires is described, for example, in U.S. Pat. No. 5,749,825 to Fischell et al.
However, in such a two-wire technique, due to the tortuosity of the vascular system, the physician must torque the delivery system in order to deliver the guidewires to their correct location. Because of this torquing, the two guidewires frequently tend to cross over one another and/or entangle during their use for guiding the stent delivery device. Such an entanglement or crossover, if it should occur, may result in an inability of the device to be delivered by the physician, requiring the procedure to be started anew.
There is thus a widely recognized need for, and it would be highly advantageous to have, a method for delivering stents to bifurcations devoid of the above limitations.
An object of the present invention is to provide a method of deploying a stent in a vessel bifurcation which method substantially reduces or eliminates the possibility of wire entanglement or cross-over when deploying the stent.
The invention is particularly useful in deploying stents in coronary blood vessel bifurcations, and is therefore described below with respect to such applications. It will be appreciated, however, that the invention could also be used for deploying stents in other vessel bifurcations such as peripheral blood vessels, or vessels related to the renal, gastrointestinal and reproductive systems or any other system in the body wherein a main vessel is split into two (or more) branch vessels.
According to one aspect of the present invention, there is provided a method of introducing a first and second vessel guidewire into two branches of a vessel, the method including inserting a first guidewire into a first vessel, inserting a second guidewire into said first vessel, advancing a delivery system through the first vessel over the first guidewire and the second guidewire, the delivery system having a first lumen that slidably engages the first guidewire and a second lumen alongside the first lumen that slidably engages the second guidewire, positioning the delivery system in a region of a bifurcation, retracting the second guidewire proximally until a distal end of the second guidewire is in a region of a bifurcation, and advancing the second guidewire through the second lumen into the second vessel.
According to a further aspect of the present invention, there is provided a method of deploying a stent in a bifurcation of a main vessel which separates into first and second branch vessels, the stent including a proximal end to be deployed in the main vessel on the proximal side of the bifurcation, and a distal end to be deployed in the first branch vessel on the distal side of the bifurcation. The method includes introducing the distal end of a first guidewire through the main vessel and the bifurcation into the first branch vessel, introducing the distal end of a second guidewire through the main vessel and the bifurcation into the first branch vessel, providing a stent delivery device including a main lumen for receiving the guidewire, a branch lumen, and an expandable stent, inserting the proximal end of the first guidewire into the distal end of the main lumen of the stent delivery device, inserting the proximal end of the second guidewire into the distal end of the main lumen of the stent delivery device, guiding the stent delivery device along the first guidewire through the main vessel and along the second guidewire through the branch vessel to an initial position adjacent to the proximal side of the bifurcation, retracting the second guidewire, advancing the second guidewire into the second branch vessel, advancing the stent delivery device, while tracked by the first guidewire in the first branch vessel and by the second guidewire in the second branch vessel, to the predetermined deployment position with respect to the bifurcation, to bring the distal end of the stent into the first branch vessel, while the proximal end of the stent still remains in the main vessel, radially expanding the stent, and removing the stent delivery device.
According to another aspect of the present invention, there is provided a method of introducing two guidewires into a first and a second vessel, the method including inserting a first guidewire into the first vessel, advancing a delivery system through the first vessel over the first guidewire, the delivery system having a first lumen that slidably engages the first guidewire and a second lumen alongside the first lumen, positioning the delivery system in a region of a bifurcation, and advancing a second guidewire through the second lumen into the second vessel.
According to yet another aspect of the present invention, there is provided a method of advancing a delivery system at a bifurcation, the method including advancing a delivery system over a first guidewire, the delivery system having a first lumen for insertion of the first guidewire and a second lumen for insertion of a second guidewire, wherein the first lumen and the second lumen are separated by a barrier and wherein the advancing is done by positioning a first guidewire within the first lumen, and thereafter introducing a second guidewire through the second lumen and into a second vessel.
According to a further aspect of the present invention, there is provided a method of deploying a stent in a bifurcation of a main vessel which separates into first and second branch vessels, the stent including a proximal end to be deployed in the main vessel on the proximal side of the bifurcation, and a distal end to be deployed in the first branch vessel on the distal side of the bifurcation. The method includes introducing the distal end of a first guidewire through the main vessel and the bifurcation into the first branch vessel, providing a stent delivery device including a main lumen for receiving the guidewire, a branch lumen, and an expandable stent, inserting the proximal end of the first guidewire into the distal end of the main lumen of the stent delivery device, guiding the stent delivery device along the first guidewire through the main vessel to an initial position adjacent to the proximal side of the bifurcation, moving a second guidewire through the branch lumen of the stent delivery device, advancing the second guidewire into the second branch vessel, advancing the stent delivery device, while tracked by the first guidewire in the first branch vessel, and by the second guidewire, in the second branch vessel, to the predetermined deployment position with respect to the bifurcation, to bring the distal end of the stent into the first branch vessel, while the proximal end of the stent still remains in the main vessel, radially expanding the stent, and removing the stent delivery device,
Either of the first and second guidewire may be pre-loaded in the first or second lumen, respectively. Alternatively, the first or the second guidewire may be introduced after the delivery device is advanced in the vessel.
According to further embodiments, the vessels are blood vessels, the first vessel is either a main vessel or a branch vessel and the second vessel is either a main vessel or a branch vessel.
According to further embodiments, the delivery system is a catheter with a stent. The stent has an optional side hole for placing one of the guidewires through so as to enter a branch vessel. The side hole may be the same or different than other openings in the wall of the stent. The stent is either self-expandable, or expandable by an inflatable balloon.
Unless otherwise defined, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this invention belongs. Although methods and materials similar or equivalent to those described herein can be used in the practice or testing of the present invention, suitable methods and materials are described below. In case of conflict, the patent specification, including definitions, will control. In addition, the materials, methods, and examples arc illustrative only and not intended to be limiting.
The invention is herein described, by way of example only, with reference to the accompanying drawings. With specific reference now to the drawings in detail, it is stressed that the particulars shown are by way of example and for purposes of illustrative discussion of the preferred embodiments of the present invention only, and are presented in the cause of providing what is believed to be the most useful and readily understood description of the principles and conceptual aspects of the invention. In this regard, no attempt is made to show structural details of the invention in more detail than is necessary for a fundamental understanding of the invention, the description taken with the drawings making apparent to those skilled in the art how the several forms of the invention may be embodied in practice.
In the drawings:
The present invention is of a method for deploying a stent at or near a bifurcation. Specifically, the method of the present invention allows insertion of two wires into two branches of a vessel while avoiding wire entanglement.
For purposes of better understanding the present invention, as illustrated in
The stent to be deployed is generally designated 8. It includes a proximal end 8A to be deployed in the main vessel 3, and a distal end 8B to be deployed in the main vessel continuation 4. For this purpose, it is delivered by a stent delivery device, generally designated 10, to its precise longitudinal position and radial orientation before it is so deployed. The stent delivery device 10 illustrated in
The prior art technique illustrated in
As briefly described above, a serious problem with the two-wire technique illustrated in
Reference is now made to
In an alternative embodiment, both guidewires 21, 22 are initially placed in the branch vessel 5, and delivery system 20 is advanced over the two wires. In the alternative embodiment just described, main guidewire 21 is retracted and subsequently advanced through main vessel 3 and into main vessel continuation 4. It is essential that guidewires 21 and 22 are both located in the same vessel, whether that vessel is the main vessel 3, main vessel continuation 4, or branch vessel 5. In this way, crossover and entanglement of the wires is minimized.
The method described above is particularly useful for rapid exchange systems, such as those disclosed in U.S. Provisional Patent Application Ser. No. 60/413,552, filed on Sep. 26, 2002 and incorporated by reference herein in its entirety, and described further hereinbelow, and any other rapid exchange system used in stent delivery. The method may also be used for any other delivery system, including over-the wire systems which are well known in the art, as well as systems such as the ones disclosed in pending U.S. patent application Ser. No. 09/455,299, filed Dec. 6, 1999; Ser. No. 09/1741,761, filed Dec. 18, 2000; and Ser. No. 09/663,111 filed Sep. 15, 2000, all of which are incorporated herein by reference in their entireties and described finer hereinbelow. Furthermore, this method may be useful for a dual stent system, in which a main stent and a side branch stent, or two portions of one stent, are used in the bifurcation. This type of stent may be useful, for example, for drug delivery into a bifurcated vessel.
Reference is now made to
As shown in
In one embodiment of the invention, the branch guidewire 22 may be pre-loaded in a branch lumen 14 of the delivery device 20, with the distal end of branch guidewire 22 protruding from a side of the stent, preferably from a designated side hole 30, so that the branch guidewire 22 is moved with the delivery device 20 to the initial position, a preferred embodiment of which is illustrated in
In an alternative embodiment the branch guidewire 22 would be inserted into branch lumen 14 of the delivery device 20 only after the delivery device 20 has been moved to its initial position. In both embodiments, the distal end of branch guidewire 22 could protrude through side opening 30 in the stent, or through one of the cellular or spiral spaces in the stent or any other opening, if no side opening is present.
In either case, when the delivery device 20 has been moved to the vicinity of its initial position, the branch guidewire 22 is manipulated from its proximal end so that its distal end is advanced into the branch vessel 5, as shown in
The delivery device 20 is then further advanced or retracted as the case may be, to its final, stent-deployment position, a preferred embodiment of which is shown in
In an alternative embodiment, shown in
It will also be appreciated that if the bifurcation 2 has already received an additional guidewire then this additional guidewire, which is not utilized in the stent positioning methods described herein, is to be removed prior to inflation of the balloon 26. If the additional guidewire 66 is not so removed, it will be trapped between the expanded stent 8 and the vessel wall. The main guidewire and/or the branch guidewire will typically be last to be removed from the patient vascular system.
It should be noted that in this preferred embodiment the branch guidewire 22 is not initially placed into the bifurcation 2 as in the prior art described above with respect to
In an alternative embodiment, shown in
The delivery device 20 may be of a similar construction as that disclosed in pending U.S. patent application Ser. No. 09/455,299, filed Dec. 6, 1999; Ser. No. 09/741,761, filed Dec. 18, 2000; and Ser. No. 09/663,111 filed Sep. 15, 2000, all of which are incorporated herein by reference in their entireties. In other embodiments, the delivery device 20 may be of a similar construction as other dual lumen delivery devices, such as the one disclosed in U.S. Pat. No. 5,749,825 to Fischell et al.
Briefly, as shown in
In an alternative embodiment of the present invention, a rapid exchange delivery system is used, such as the one described in U.S. Provisional Patent Application Ser. No. 60/413,552, filed on Sep. 26, 2002 and incorporated by reference herein in its entirety. A system such as the one described is shown in
As shown in
In alternative embodiments, delivery device 20 is used for delivering guidewires 21 and 22 to a main vessel continuation 4 and a branch vessel 5, without having a stent placed on the delivery device 20. An example of such a delivery device includes a catheter with a two-headed balloon or a dual lumen balloon. In this embodiment, delivery device 20 may be of a similar construction as that disclosed in pending U.S. patent application Ser. No. 09/816,690, filed Mar. 22, 2001, and incorporated by reference in its entirety.
Briefly, delivery device 20 has two lumens 32 and 34 passing therethrough. As can be seen in
While the invention has been described with respect to two preferred embodiments, it will be appreciated that these are set forth merely for purposes of example, and that many other variations, modifications and applications or the invention may be made. It should be readily apparent that either the two-wire method illustrated in
Although the invention has been described in conjunction with specific embodiments thereof, it is evident that many alternatives, modifications and variations will be apparent to those skilled in the art. Accordingly, it is intended to embrace all such alternatives, modifications and variations that fall within the spirit and broad scope of the appended claims. All publications, patents and patent applications mentioned in this specification are herein incorporated in their entirety by reference into the specification, to the same extent as if each individual publication, patent or patent application was specifically and individually indicated to be incorporated herein by reference. In addition, citation or identification of any reference in this application shall not be construed as an admission that such reference is available as prior art to the present invention.
This application is a continuation of U.S. patent application Ser. No. 10/320,719, filed Dec. 17, 2002, now issued as U.S. Pat. No. 7,591,846, which application is incorporated herein by reference in its entirety.
Number | Name | Date | Kind |
---|---|---|---|
1596754 | Moschelle | Aug 1926 | A |
3657744 | Ersek | Apr 1972 | A |
3872893 | Roberts | Mar 1975 | A |
4140126 | Choudhury | Feb 1979 | A |
4309994 | Grunwald | Jan 1982 | A |
4385631 | Uthmann | May 1983 | A |
4410476 | Redding et al. | Oct 1983 | A |
4413989 | Schjeldahl et al. | Nov 1983 | A |
4421810 | Rasmussen | Dec 1983 | A |
4453545 | Inoue | Jun 1984 | A |
4503569 | Dotter | Mar 1985 | A |
4552554 | Gould et al. | Nov 1985 | A |
4681570 | Dalton | Jul 1987 | A |
4689174 | Lupke | Aug 1987 | A |
4731055 | Melinyshyn et al. | Mar 1988 | A |
4733665 | Palmaz | Mar 1988 | A |
4739762 | Palmaz | Apr 1988 | A |
4759748 | Reed | Jul 1988 | A |
4762128 | Rosenbluth | Aug 1988 | A |
4769029 | Patel | Sep 1988 | A |
4819664 | Nazari | Apr 1989 | A |
4872874 | Taheri | Oct 1989 | A |
4878495 | Grayzel | Nov 1989 | A |
4896670 | Crittenden | Jan 1990 | A |
4900314 | Quackenbush | Feb 1990 | A |
4906244 | Pinchuk et al. | Mar 1990 | A |
4909258 | Kuntz et al. | Mar 1990 | A |
4946464 | Pevsner | Aug 1990 | A |
4957501 | Lahille et al. | Sep 1990 | A |
4957508 | Kaneko et al. | Sep 1990 | A |
4964850 | Bouton et al. | Oct 1990 | A |
4983167 | Sahota | Jan 1991 | A |
4994071 | MacGregor | Feb 1991 | A |
5042976 | Ishitsu et al. | Aug 1991 | A |
5054501 | Chuttani et al. | Oct 1991 | A |
5059170 | Cameron | Oct 1991 | A |
5059177 | Towne et al. | Oct 1991 | A |
5061240 | Cherian | Oct 1991 | A |
5064435 | Porter | Nov 1991 | A |
5085664 | Bozzo | Feb 1992 | A |
5102403 | Alt | Apr 1992 | A |
5102417 | Palmaz | Apr 1992 | A |
5104404 | Wolff | Apr 1992 | A |
5117831 | Jang et al. | Jun 1992 | A |
5122125 | Deuss | Jun 1992 | A |
5135536 | Hillstead | Aug 1992 | A |
5147317 | Shank et al. | Sep 1992 | A |
5159920 | Condon et al. | Nov 1992 | A |
5176617 | Fischell et al. | Jan 1993 | A |
5192297 | Hull | Mar 1993 | A |
5195984 | Schatz | Mar 1993 | A |
5211683 | Maginot | May 1993 | A |
5217440 | Frassica | Jun 1993 | A |
5222971 | Willard et al. | Jun 1993 | A |
5226913 | Pinchuk | Jul 1993 | A |
5234457 | Andersen | Aug 1993 | A |
5236446 | Dumon | Aug 1993 | A |
5244619 | Burnham | Sep 1993 | A |
5254619 | Ando | Oct 1993 | A |
5257974 | Cox | Nov 1993 | A |
5263932 | Jang | Nov 1993 | A |
5282472 | Companion et al. | Feb 1994 | A |
5304220 | Maginot | Apr 1994 | A |
5320605 | Sahota | Jun 1994 | A |
5324257 | Osborne et al. | Jun 1994 | A |
5337733 | Bauerfeind et al. | Aug 1994 | A |
5338300 | Cox | Aug 1994 | A |
5342295 | Imran | Aug 1994 | A |
5342297 | Jang | Aug 1994 | A |
5342387 | Summers | Aug 1994 | A |
5350395 | Yock | Sep 1994 | A |
5383892 | Cardon et al. | Jan 1995 | A |
5387235 | Chuter | Feb 1995 | A |
5395332 | Ressemann et al. | Mar 1995 | A |
5395334 | Keith et al. | Mar 1995 | A |
5404887 | Prather | Apr 1995 | A |
5409458 | Khairkhahan et al. | Apr 1995 | A |
5413581 | Goy | May 1995 | A |
5413586 | Dibie et al. | May 1995 | A |
5417208 | Winkler | May 1995 | A |
5425765 | Tiefenbrun et al. | Jun 1995 | A |
5437638 | Bowman | Aug 1995 | A |
5443497 | Venbrux | Aug 1995 | A |
5445624 | Jimenez | Aug 1995 | A |
5449373 | Pinchasik et al. | Sep 1995 | A |
5449382 | Dayton | Sep 1995 | A |
5456694 | Marin et al. | Oct 1995 | A |
5456712 | Maginot | Oct 1995 | A |
5456714 | Owen | Oct 1995 | A |
5458605 | Klemm | Oct 1995 | A |
5462530 | Jang | Oct 1995 | A |
5476471 | Shifrin et al. | Dec 1995 | A |
5489271 | Andersen | Feb 1996 | A |
5489295 | Piplani et al. | Feb 1996 | A |
5496292 | Burnham | Mar 1996 | A |
5505702 | Arney | Apr 1996 | A |
5507768 | Lau et al. | Apr 1996 | A |
5507769 | Marin et al. | Apr 1996 | A |
5514154 | Lau et al. | May 1996 | A |
5514178 | Torchio | May 1996 | A |
5522801 | Wang | Jun 1996 | A |
5531788 | Dibie et al. | Jul 1996 | A |
5545132 | Fagan et al. | Aug 1996 | A |
5549553 | Ressemann et al. | Aug 1996 | A |
5549554 | Miraki | Aug 1996 | A |
5562620 | Klein et al. | Oct 1996 | A |
5562724 | Vorwerk et al. | Oct 1996 | A |
5562725 | Schmitt et al. | Oct 1996 | A |
5562726 | Chuter | Oct 1996 | A |
5569295 | Lam | Oct 1996 | A |
5571087 | Ressemann et al. | Nov 1996 | A |
5575771 | Walinsky | Nov 1996 | A |
5575817 | Martin | Nov 1996 | A |
5575818 | Pinchuk | Nov 1996 | A |
5591228 | Edoga | Jan 1997 | A |
5593442 | Klein | Jan 1997 | A |
5607444 | Lam | Mar 1997 | A |
5609605 | Marshall et al. | Mar 1997 | A |
5609625 | Piplani et al. | Mar 1997 | A |
5609627 | Goicoechea et al. | Mar 1997 | A |
5609629 | Fearnot et al. | Mar 1997 | A |
5613949 | Miraki | Mar 1997 | A |
5613980 | Chauhan | Mar 1997 | A |
5613981 | Boyle et al. | Mar 1997 | A |
5617878 | Taheri | Apr 1997 | A |
5626600 | Horzewski et al. | May 1997 | A |
5628788 | Pinchuk | May 1997 | A |
5632762 | Myler | May 1997 | A |
5632763 | Glastra | May 1997 | A |
5632772 | Alcime et al. | May 1997 | A |
5634902 | Johnson et al. | Jun 1997 | A |
5639278 | Dereume et al. | Jun 1997 | A |
5643340 | Nunokawa | Jul 1997 | A |
5653743 | Martin | Aug 1997 | A |
5662614 | Edoga | Sep 1997 | A |
5669924 | Shaknovich | Sep 1997 | A |
5669932 | Fischell et al. | Sep 1997 | A |
5676696 | Marcade | Oct 1997 | A |
5676697 | McDonald | Oct 1997 | A |
5679400 | Tuch | Oct 1997 | A |
5683451 | Lenker et al. | Nov 1997 | A |
5690642 | Osborne et al. | Nov 1997 | A |
5693084 | Chuter | Dec 1997 | A |
5693086 | Goicoechea et al. | Dec 1997 | A |
5693088 | Lazarus | Dec 1997 | A |
5697971 | Fischell et al. | Dec 1997 | A |
5707354 | Salmon et al. | Jan 1998 | A |
5709713 | Evans et al. | Jan 1998 | A |
5716365 | Goicoechea et al. | Feb 1998 | A |
5718683 | Ressemann et al. | Feb 1998 | A |
5718724 | Goicoechea et al. | Feb 1998 | A |
5720735 | Dorros | Feb 1998 | A |
5723004 | Dereume et al. | Mar 1998 | A |
5724977 | Yock et al. | Mar 1998 | A |
5728158 | Lau et al. | Mar 1998 | A |
5733303 | Israel et al. | Mar 1998 | A |
5735893 | Lau et al. | Apr 1998 | A |
5746766 | Edoga | May 1998 | A |
5749825 | Fischell et al. | May 1998 | A |
5749848 | Jang et al. | May 1998 | A |
5755734 | Richter et al. | May 1998 | A |
5755735 | Richter et al. | May 1998 | A |
5755770 | Ravenscroft | May 1998 | A |
5755771 | Penn et al. | May 1998 | A |
5755778 | Kleshinski | May 1998 | A |
5762631 | Klein | Jun 1998 | A |
5776101 | Goy | Jul 1998 | A |
5776161 | Globerman | Jul 1998 | A |
5776180 | Goicoechea et al. | Jul 1998 | A |
5782906 | Marshall et al. | Jul 1998 | A |
5800450 | Lary et al. | Sep 1998 | A |
5800508 | Goicoechea et al. | Sep 1998 | A |
5814061 | Osborne et al. | Sep 1998 | A |
5817126 | Imran | Oct 1998 | A |
5824008 | Bolduc et al. | Oct 1998 | A |
5824036 | Lauterjung | Oct 1998 | A |
5824039 | Piplani et al. | Oct 1998 | A |
5824040 | Cox et al. | Oct 1998 | A |
5824041 | Lenker et al. | Oct 1998 | A |
5824042 | Lombardi et al. | Oct 1998 | A |
5824044 | Quiachon et al. | Oct 1998 | A |
5827320 | Richter et al. | Oct 1998 | A |
5833650 | Imran | Nov 1998 | A |
5836966 | St. Germain | Nov 1998 | A |
5837008 | Berg et al. | Nov 1998 | A |
5843031 | Hermann et al. | Dec 1998 | A |
5843160 | Rhodes | Dec 1998 | A |
5843164 | Frantzen et al. | Dec 1998 | A |
5846204 | Solomon | Dec 1998 | A |
5851210 | Torossian | Dec 1998 | A |
5851464 | Davila et al. | Dec 1998 | A |
5855600 | Alt | Jan 1999 | A |
5855601 | Bessler et al. | Jan 1999 | A |
5865178 | Yock | Feb 1999 | A |
5868777 | Lam | Feb 1999 | A |
5871536 | Lazarus | Feb 1999 | A |
5871537 | Holman et al. | Feb 1999 | A |
5891133 | Murphy-Chutorian | Apr 1999 | A |
5897588 | Hull et al. | Apr 1999 | A |
5906640 | Penn et al. | May 1999 | A |
5907893 | Zadno-Azizi et al. | Jun 1999 | A |
5913895 | Burpee et al. | Jun 1999 | A |
5913897 | Corso, Jr. et al. | Jun 1999 | A |
5921958 | Ressemann et al. | Jul 1999 | A |
5922020 | Klein et al. | Jul 1999 | A |
5928248 | Acker | Jul 1999 | A |
5938682 | Hojebane et al. | Aug 1999 | A |
5938696 | Goicoechea et al. | Aug 1999 | A |
5948016 | Jang | Sep 1999 | A |
5951599 | McCrory | Sep 1999 | A |
5961548 | Shmulewitz | Oct 1999 | A |
5967986 | Cimochowski et al. | Oct 1999 | A |
5972018 | Israel et al. | Oct 1999 | A |
6007517 | Anderson | Dec 1999 | A |
6013054 | Jiun Yan | Jan 2000 | A |
6013091 | Ley et al. | Jan 2000 | A |
6017324 | Tu et al. | Jan 2000 | A |
6017363 | Hojeibane | Jan 2000 | A |
6024763 | Lenker et al. | Feb 2000 | A |
6030414 | Taheri | Feb 2000 | A |
6033434 | Borghi | Mar 2000 | A |
6033435 | Penn et al. | Mar 2000 | A |
6036682 | Lange et al. | Mar 2000 | A |
6039749 | Marin et al. | Mar 2000 | A |
6042597 | Kveen et al. | Mar 2000 | A |
6045557 | White et al. | Apr 2000 | A |
6048361 | Von Oepen | Apr 2000 | A |
6051020 | Goicoechea et al. | Apr 2000 | A |
6056775 | Borghi et al. | May 2000 | A |
6059823 | Holman et al. | May 2000 | A |
6059824 | Taheri | May 2000 | A |
6066168 | Lau et al. | May 2000 | A |
6068655 | Seguin et al. | May 2000 | A |
6071285 | Lashinski et al. | Jun 2000 | A |
6086611 | Duffy et al. | Jul 2000 | A |
6090127 | Globerman | Jul 2000 | A |
6090128 | Douglas | Jul 2000 | A |
6096073 | Webster et al. | Aug 2000 | A |
6099497 | Adams et al. | Aug 2000 | A |
6102938 | Evans et al. | Aug 2000 | A |
6117117 | Mauch | Sep 2000 | A |
6117156 | Richter et al. | Sep 2000 | A |
6126685 | Lenker et al. | Oct 2000 | A |
6129738 | Lashinski et al. | Oct 2000 | A |
6129754 | Kanesaka et al. | Oct 2000 | A |
6142973 | Carleton et al. | Nov 2000 | A |
6152945 | Bachinski et al. | Nov 2000 | A |
6165195 | Wilson et al. | Dec 2000 | A |
6165197 | Yock | Dec 2000 | A |
6165214 | Lazarus | Dec 2000 | A |
6179867 | Cox | Jan 2001 | B1 |
6183506 | Penn et al. | Feb 2001 | B1 |
6183509 | Dibie | Feb 2001 | B1 |
6190353 | Makower et al. | Feb 2001 | B1 |
6190403 | Fischell et al. | Feb 2001 | B1 |
6193746 | Strecker | Feb 2001 | B1 |
6203568 | Lombardi et al. | Mar 2001 | B1 |
6203569 | Wijay | Mar 2001 | B1 |
6210380 | Mauch | Apr 2001 | B1 |
6210429 | Vardi et al. | Apr 2001 | B1 |
6217527 | Selmon et al. | Apr 2001 | B1 |
6221080 | Power | Apr 2001 | B1 |
6221090 | Wilson | Apr 2001 | B1 |
6221098 | Wilson et al. | Apr 2001 | B1 |
6231563 | White et al. | May 2001 | B1 |
6231598 | Berry et al. | May 2001 | B1 |
6231600 | Zhong | May 2001 | B1 |
6235051 | Murphy | May 2001 | B1 |
6241762 | Shanley | Jun 2001 | B1 |
6251133 | Richter et al. | Jun 2001 | B1 |
6258073 | Mauch | Jul 2001 | B1 |
6258099 | Mareiro et al. | Jul 2001 | B1 |
6258116 | Hojeibane | Jul 2001 | B1 |
6258121 | Yang et al. | Jul 2001 | B1 |
6261273 | Ruiz | Jul 2001 | B1 |
6261305 | Marotta et al. | Jul 2001 | B1 |
6261319 | Kveen et al. | Jul 2001 | B1 |
6264682 | Wilson et al. | Jul 2001 | B1 |
6273911 | Cox et al. | Aug 2001 | B1 |
6273913 | Wright et al. | Aug 2001 | B1 |
6287314 | Lee et al. | Sep 2001 | B1 |
6290673 | Shanley | Sep 2001 | B1 |
6293967 | Shanley | Sep 2001 | B1 |
6299634 | Bergeron | Oct 2001 | B1 |
6302906 | Goicoechea et al. | Oct 2001 | B1 |
6309412 | Lau et al. | Oct 2001 | B1 |
6309414 | Rolando et al. | Oct 2001 | B1 |
6312459 | Huang et al. | Nov 2001 | B1 |
6325821 | Gaschino et al. | Dec 2001 | B1 |
6325826 | Vardi et al. | Dec 2001 | B1 |
6334870 | Ehr et al. | Jan 2002 | B1 |
6346089 | Dibie | Feb 2002 | B1 |
6350278 | Lenker et al. | Feb 2002 | B1 |
6355060 | Lenker et al. | Mar 2002 | B1 |
6361544 | Wilson et al. | Mar 2002 | B1 |
6361555 | Wilson | Mar 2002 | B1 |
6371978 | Wilson | Apr 2002 | B1 |
6383213 | Wilson et al. | May 2002 | B2 |
6383215 | Sass | May 2002 | B1 |
6387120 | Wilson et al. | May 2002 | B2 |
6395018 | Castaneda | May 2002 | B1 |
6398792 | O'Connor | Jun 2002 | B1 |
6398804 | Spielberg | Jun 2002 | B1 |
6428567 | Wilson et al. | Aug 2002 | B2 |
6428570 | Globerman | Aug 2002 | B1 |
6432133 | Lau et al. | Aug 2002 | B1 |
6436104 | Hojeibane | Aug 2002 | B2 |
6436134 | Richter et al. | Aug 2002 | B2 |
6468302 | Cox et al. | Oct 2002 | B2 |
6475208 | Mauch | Nov 2002 | B2 |
6478816 | Kveen et al. | Nov 2002 | B1 |
6482211 | Choi | Nov 2002 | B1 |
6485511 | Lau et al. | Nov 2002 | B2 |
6494905 | Zedler et al. | Dec 2002 | B1 |
6508836 | Wilson et al. | Jan 2003 | B2 |
6511504 | Lau et al. | Jan 2003 | B1 |
6511505 | Cox et al. | Jan 2003 | B2 |
6520988 | Colombo et al. | Feb 2003 | B1 |
6527799 | Shanley | Mar 2003 | B2 |
6540719 | Bigus et al. | Apr 2003 | B2 |
6540779 | Richter et al. | Apr 2003 | B2 |
6572647 | Supper et al. | Jun 2003 | B1 |
6576009 | Ryan et al. | Jun 2003 | B2 |
6579309 | Loos et al. | Jun 2003 | B1 |
6579312 | Wilson et al. | Jun 2003 | B2 |
6582394 | Reiss et al. | Jun 2003 | B1 |
6582459 | Lau et al. | Jun 2003 | B1 |
6596020 | Vardi et al. | Jul 2003 | B2 |
6596022 | Lau et al. | Jul 2003 | B2 |
6599315 | Wilson | Jul 2003 | B2 |
6599316 | Vardi et al. | Jul 2003 | B2 |
6602284 | Cox et al. | Aug 2003 | B2 |
6641609 | Globerman | Nov 2003 | B2 |
6645241 | Strecker | Nov 2003 | B1 |
6652573 | von Oepen | Nov 2003 | B2 |
6669717 | Marotta et al. | Dec 2003 | B2 |
6676667 | Mareiro et al. | Jan 2004 | B2 |
6679911 | Burgermeister | Jan 2004 | B2 |
6682536 | Vardi et al. | Jan 2004 | B2 |
6689156 | Davidson et al. | Feb 2004 | B1 |
6692483 | Vardi et al. | Feb 2004 | B2 |
6695877 | Brucker et al. | Feb 2004 | B2 |
6706062 | Vardi et al. | Mar 2004 | B2 |
6709440 | Callol et al. | Mar 2004 | B2 |
6736841 | Musbach et al. | May 2004 | B2 |
6770092 | Richter | Aug 2004 | B2 |
6780174 | Mauch | Aug 2004 | B2 |
6802856 | Wilson | Oct 2004 | B2 |
6827735 | Greenberg | Dec 2004 | B2 |
6827736 | Perouse | Dec 2004 | B2 |
6843803 | Ryan et al. | Jan 2005 | B2 |
6852124 | Cox et al. | Feb 2005 | B2 |
6855125 | Shanley | Feb 2005 | B2 |
6884258 | Vardi et al. | Apr 2005 | B2 |
6890349 | McGuckin, Jr. et al. | May 2005 | B2 |
6896699 | Wilson et al. | May 2005 | B2 |
6908477 | McGuckin, Jr. et al. | Jun 2005 | B2 |
6942689 | Majercak | Sep 2005 | B2 |
6955687 | Richter et al. | Oct 2005 | B2 |
6955688 | Wilson et al. | Oct 2005 | B2 |
6962602 | Vardi et al. | Nov 2005 | B2 |
6980174 | Flasza et al. | Dec 2005 | B2 |
7056323 | Mareiro et al. | Jun 2006 | B2 |
7105019 | Hojeibane | Sep 2006 | B2 |
7118593 | Davidson et al. | Oct 2006 | B2 |
7125419 | Sequin et al. | Oct 2006 | B2 |
7163553 | Limon | Jan 2007 | B2 |
7220275 | Davidson et al. | May 2007 | B2 |
7238197 | Sequin et al. | Jul 2007 | B2 |
7244853 | Schreiber et al. | Jul 2007 | B2 |
7252679 | Fischell et al. | Aug 2007 | B2 |
7344514 | Shanley | Mar 2008 | B2 |
7387639 | Bourang et al. | Jun 2008 | B2 |
7591846 | Vardi | Sep 2009 | B2 |
20010037146 | Lau et al. | Nov 2001 | A1 |
20010039448 | Dibie | Nov 2001 | A1 |
20020013618 | Marotta et al. | Jan 2002 | A1 |
20020032478 | Boekstegers et al. | Mar 2002 | A1 |
20020035392 | Wilson | Mar 2002 | A1 |
20020058990 | Jang | May 2002 | A1 |
20020111675 | Wilson | Aug 2002 | A1 |
20020123790 | White et al. | Sep 2002 | A1 |
20020156516 | Vardi et al. | Oct 2002 | A1 |
20020165604 | Shanley | Nov 2002 | A1 |
20020183763 | Callol et al. | Dec 2002 | A1 |
20020193872 | Trout, III et al. | Dec 2002 | A1 |
20020193873 | Brucker et al. | Dec 2002 | A1 |
20030009209 | Hojelbane | Jan 2003 | A1 |
20030009214 | Shanley | Jan 2003 | A1 |
20030014102 | Hong et al. | Jan 2003 | A1 |
20030125802 | Callol et al. | Jul 2003 | A1 |
20040015227 | Vardi et al. | Jan 2004 | A1 |
20040049259 | Strecker | Mar 2004 | A1 |
20040148006 | Davidson et al. | Jul 2004 | A1 |
20050075722 | Chuter | Apr 2005 | A1 |
20050245941 | Vardi et al. | Nov 2005 | A1 |
20070179591 | Baker et al. | Aug 2007 | A1 |
20080255581 | Bourang et al. | Oct 2008 | A1 |
Number | Date | Country |
---|---|---|
2318314 | Jul 1999 | CA |
2403826 | Sep 2001 | CA |
9014845.2 | Sep 1991 | DE |
29701758 | Mar 1997 | DE |
60036233 | May 2008 | DE |
0891751 | Jan 1999 | EP |
0897700 | Feb 1999 | EP |
0904745 | Mar 1999 | EP |
1031328 | Aug 2000 | EP |
0884028 | Feb 2002 | EP |
0646365 | Jan 2004 | EP |
0684022 | Feb 2004 | EP |
0897698 | Jun 2004 | EP |
1182989 | Dec 2004 | EP |
EP 0551179 | Apr 2005 | EP |
1157674 | Jul 2005 | EP |
0804907 | Nov 2005 | EP |
1031330 | Nov 2005 | EP |
0876805 | Aug 2006 | EP |
1512380 | Aug 2007 | EP |
2678508 | Jan 1993 | FR |
8-299456 | Nov 1996 | JP |
WO 8806026 | Aug 1988 | WO |
WO 9013332 | Nov 1990 | WO |
WO 9112779 | Sep 1991 | WO |
WO 9219308 | Nov 1992 | WO |
WO 9508965 | Apr 1995 | WO |
WO 9521592 | Aug 1995 | WO |
WO 9629955 | Oct 1996 | WO |
WO 9634580 | Nov 1996 | WO |
WO 9641592 | Dec 1996 | WO |
WO 9709946 | Mar 1997 | WO |
WO 9716217 | May 1997 | WO |
WO 9726936 | Jul 1997 | WO |
WO 9732544 | Sep 1997 | WO |
WO 9733532 | Sep 1997 | WO |
WO 9741803 | Nov 1997 | WO |
WO 9745073 | Dec 1997 | WO |
WO 9817204 | Apr 1998 | WO |
WO 9819628 | May 1998 | WO |
WO 9835634 | Aug 1998 | WO |
WO 9836709 | Aug 1998 | WO |
WO 9844871 | Oct 1998 | WO |
WO 9848733 | Nov 1998 | WO |
WO 9852497 | Nov 1998 | WO |
WO 9900835 | Jan 1999 | WO |
WO 9915103 | Apr 1999 | WO |
WO 9917680 | Apr 1999 | WO |
WO 9934749 | Jul 1999 | WO |
WO 9935979 | Jul 1999 | WO |
WO 9936002 | Jul 1999 | WO |
WO 9939661 | Aug 1999 | WO |
WO 9949793 | Oct 1999 | WO |
WO 9958059 | Nov 1999 | WO |
WO 9965419 | Dec 1999 | WO |
WO 0000104 | Jan 2000 | WO |
WO 0012166 | Mar 2000 | WO |
WO 0013613 | Mar 2000 | WO |
WO 0053122 | Sep 2000 | WO |
WO 0074595 | Dec 2000 | WO |
WO 0121095 | Mar 2001 | WO |
WO 0121109 | Mar 2001 | WO |
WO 0121244 | Mar 2001 | WO |
WO 0170299 | Sep 2001 | WO |
WO 02068012 | Sep 2002 | WO |
WO 02076333 | Oct 2002 | WO |
WO 02094336 | Nov 2002 | WO |
WO 03055414 | Jul 2003 | WO |
WO 2004026180 | Apr 2004 | WO |
WO 2006124162 | Nov 2006 | WO |
Entry |
---|
Caputo et al., “Stent Jail: A Minimum-Security Prison,” The American Journal of Cardiology, vol. 77, pp. 1226-1230, Jun. 1, 1996. |
Carrie et al., ““T”-Shaped Stent Placement: A Technique for the Treatment of Dissected Bifurcation Lesions,” Catheterization and Cardiovascular Diagnosis, vol. 37, pp. 311-313, 1996. |
Chevalier et al., “Placement of Coronary Stents in Bifurcation Lesions by the “Culotte” Technique,” The American Journal of Cardiology, vol. 82, pp. 943-949, Oct. 15, 1998. |
Colombo et al., ““Kissing” Stents for Bifurcational Coronary Lesion,” Catheterization and Cardiovascular Diagnosis, vol. 30, pp. 327-330, 1993. |
U.S. Appl. No. 08/642,297, filed May 3, 1996, to Richter et al. |
U.S. Appl. No. 09/325,996, filed Jun. 4, 1999, to Vardi et al. |
U.S. Appl. No. 09/533,616, filed Mar. 22, 2000, to Vardi et al. |
U.S. Appl. No. 09/614,472, filed Jul. 11, 2000, to Davidson et al. |
U.S. Appl. No. 09/663,111, filed Sep. 15, 2000, to Davidson et al. |
Dichek et al., “Seeding of Intravascular Stents with Genetically Engineered Endothelial Cells,” Circulation,vol. 80, No. 5, pp. 1347-1353, Nov. 1989. |
Fischman et al., “A Randomized Comparison of Coronary-Stent Placement and Balloon Angioplasty in the Treatment of Coronary Artery Disease,” New England Journal of Medicine, vol. 331, No. 8, pp. 496-501, Aug. 25, 1994. |
Katoh et al., “New Double Wire Technique to Stent Ostial Lesions,” Catheterization and Cardiovascular Diagnosis, vol. 40, pp. 400-402, 1997. |
Lear et al., “The Northridge Earthquake as a Trigger for Acute Myocardial Infarction,” 1 page, 1996. |
Lewis et al., “Acute Procedural Results in the Treatment of 30 Coronary Artery Bifurcation Lesions with a Double-Wire Atherectomy Technique for Side-Branch Protection,” American Heart Journal, vol. 127, No. 6, pp. 1600-1607, 1994. |
Nakamura et al., “Techniques for Palmaz-Schatz Stent Deployment in Lesions with a Large Side Branch,” Catheterization and Cardiovascular Diagnosis, vol. 34, pp. 353-361, 1995. |
Satler et al. “Bifurcation Disease: To Treat or Not to Treat,” Catheterization and Cardiovascular Interventions, vol. 50, pp. 411-412, 2000. |
SCIMED Life Systems, Inc., “TRIO 14 PTCA Catheter, Re-Engineering Over-The-Wire Balloon Technology,” Brochure, 4 pages, 1994. |
Serruys et al., “A Comparison of Balloon Expandable-Stent Implantation with Balloon Angioplasty in Patients with Coronary Artery Disease,” The New England Journal of Medicine, vol. 331, No. 8, pp. 489-495, Aug. 25, 1994. |
Yamashita et al., “Bifurcation Lesions: Two Stents Versus One Stent—Immediate and Follow-up Results,” Journal of the American College of Cardiology, vol. 35, No. 5, pp. 1145-1151, Apr. 2000. |
Number | Date | Country | |
---|---|---|---|
20090326634 A1 | Dec 2009 | US |
Number | Date | Country | |
---|---|---|---|
Parent | 10320719 | Dec 2002 | US |
Child | 12555501 | US |