Patent Grant
10603197
The present invention relates generally to implantable medical devices, and specifically to delivery tools and implantable stent-grafts.
Endovascular prostheses are sometimes used to treat aortic aneurysms. Such treatment includes implanting a stent or stent-graft within the diseased vessel to bypass the anomaly. An aneurysm is a sac formed by the dilation of the wall of the artery. Aneurysms may be congenital, but are usually caused by disease or, occasionally, by trauma. Aortic aneurysms which commonly form between the renal arteries and the iliac arteries are referred to as abdominal aortic aneurysms (“AAAs”). Other aneurysms occur in the aorta, such as thoracic aortic aneurysms (“TAAs”) and aortic uni-iliac (“AUI”) aneurysms. A TAA may occur downstream the aortic arch, i.e., in the descending aorta. Alternatively, a TAA may occur in the aortic arch itself, where the aorta branches to supply the brachiocephalic, left carotid and subclavian arteries, or may occur in the ascending aorta.
Endo-Vascular Aneurysm Repair (EVAR) has transformed the practice of treatment of aortic aneurysms from an open surgical approach to a much less invasive surgical approach. The first step of an endovascular intervention usually requires introducing a delivery system into the vasculature of a subject. If the crossing profile, i.e., the external diameter, of the delivery system is 24 Fr or lower (3 Fr=1 millimeter), a true percutaneous approach may be used, because vascular closure devices are available for proper closure of such puncture sites.
Blood vessels occasionally weaken or even rupture. For example, in the aortic artery, the vascular wall can weaken or tear, resulting in dangerous conditions such as aneurysm and dissection. Treatment of such conditions can be performed by implanting a prosthesis within the vascular system using minimally-invasive surgical procedures. An endoluminal prosthesis typically includes one or more stents affixed to graft material and is delivered to the treatment site by endovascular insertion. Once the endoluminal prosthesis is radially enlarged, it should remain in place indefinitely by self-attachment to the vessel wall, acting as a substitute vessel for the flow of blood or other fluids.
Aortic dissection is a tear or partial tear in the inner wall of the aorta, which causes blood to flow between the layers of the wall of the aorta, forcing the layers apart. Aortic dissections may be divided into two types in accordance with the Stanford classification: Type A dissections involve the ascending aorta and/or aortic arch, and possibly the descending aorta. Type B dissections involve the descending aorta or the arch (distal to right brachiocephalic artery origin), without involvement of the ascending aorta.
US Patent Application Publication 2007/0016281 to Melsheimer describes an introducer apparatus for deploying a self-expandable medical device, such as a stent, to a target area of a body vessel of a patient. The introducer apparatus comprises a shaft having a proximal end and a distal end, and a distal end portion disposed at the shaft distal end. The distal end portion comprises an introducer body and at least one deployment member. The introducer body is sized and shaped relative to the self-expandable medical device such that the medical device is receivable on a surface of the introducer body when the medical device is in a compressed condition. The deployment member is configured and arranged relative to the introducer body for selectively restraining the self-expandable medical device in the compressed condition on the introducer apparatus surface.
US Patent Application Publication 2013/0131783 to Shalev et al. describes medical apparatus for insertion into a mammalian body. The apparatus includes structural stent elements, at least a portion of which are shaped so as to define (a) at least one generally circumferential band, and (b) a plurality of engagement members that are joined to and extend radially inwardly from the band. The apparatus further includes an elongated latch member which is threaded through the engagement members, thereby physically latching the engagement members. The band and the engagement members are configured such that (a) when the latch member is threaded through and thus physically latches the engagement members, the engagement members retain the band in a radially-compressed state, and (b) when the latch member is removed from the engagement members, the band assumes a radially-expanded state. Other embodiments are also described.
US Patent Application Publication 2006/0190070 to Dieck et al. describes devices, systems and methods for stenting body lumens. In particular, stents are described which are advanceable directly over a guidewire and expandable within a target location of a body lumen by retraction of the guidewire and/or by releasing constraining element(s) disposed around at least a portion of the stent. Typically the constraining element(s) have the form of one or more bands or layers of material which hold the stent in an unexpanded configuration. These stent designs allow delivery to a body lumen without the need for a number of additional devices which are typically used in the delivery of conventional stents, thereby reducing the profile of the stent during delivery, increasing the flexibility of the stent during delivery to allow passage through more tortuous pathways, and allowing the delivery of branched or otherwise connected stents to body lumens, such as branched lumens.
Some applications of the present invention provide a stent-graft deployment system, which is configured to deliver and deploy a stent-graft to a lumen of a body, such as a blood vessel, e.g., an artery. For some applications, the stent-graft deployment system is used to treat an artery affected by an aneurysm and/or a dissection. The deployment system comprises at least one restraining wire, and an elongated delivery shaft, which comprises an inner shaft. The inner shaft is removably disposed in the stent-graft, which in turn is radially constrained by an outer sheath of the deployment system. The deployment system is configured such that the at least one restraining wire prevents full radial expansion of one or more longitudinal portions of the stent-graft after the outer sheath has been withdrawn from the stent-graft.
The inner shaft is shaped so as to define at least one conduit therealong, which is typically not coaxial with the inner shaft. The conduit is shaped so as to define at least first and second non-longitudinally-overlapping enclosed longitudinal segments. The conduit is also shaped so as to define a restraining longitudinal portion that is longitudinally disposed between the first and the second enclosed longitudinal segments. The deployment system is configured such that:
Typically, a proximal portion of the restraining wire is coupled to a withdrawal actuator of a control handle, such as described hereinbelow. A distal end of the restraining wire is not fixed to the delivery shaft, and is free to be proximally withdrawn from the first enclosed longitudinal segment, and thus to free the longitudinal portion of the stent-graft.
As used in the present application, including in the claims, two elements “at least partially longitudinally overlap” if at least a portion of the first element is disposed at a same longitudinal position as at least a portion of the second element, and two elements do “not longitudinally overlap” or are “non-longitudinally-overlapping” if no portion of the first element is disposed at a same longitudinal position as any portion of the second element.
Upon withdrawal of the outer sheath, the radially-compressed self-expanding stent-graft's outwardly-directed radial force, at certain locations along and around the stent-graft, is now to the restraining wire. The exposed portion of the restraining wire is short enough relative to its cross section, and hence is stiff enough, so as to act more like a restraining beam than a suturing filament. Therefore, the outwardly-directed radial force does not pull out the portion of the restraining wire disposed in the first, more distal enclosed longitudinal segment, even though the distal end of the restraining wire is not fixed to the delivery shaft. The relatively small inner diameter of the first and the second enclosed longitudinal segments also generally helps prevent the restraining wire from being prematurely pulled out of the first enclosed longitudinal segment. The relatively short length of the restraining longitudinal portion enables the restraining wire to perform its restraining function, even though the restraining wire is still flexible enough to accommodate a tortuous path through the subject's vasculature during advancing of the delivery shaft. In other words, if the restraining longitudinal portion were longer, the restraining wire would need to be so stiff that the restraining wire could not accommodate the tortuous path of the vasculature.
The flexibility of the restraining wire allows the portion of the restraining wire to extend outward from the inner shaft, when the restraining wire is disposed in the first and the second enclosed longitudinal segments. This outward extension allows the restraining wire to physically engage the longitudinal portion of the stent-graft, without any elements of the stent-graft projecting into the interior of the inner shaft. As a result, the inner shaft may be provided with a relatively small diameter, such as no more than 4 mm, which enables the delivery shaft to have a small crossing profile when loaded with the stent-graft.
For some applications, the conduit is open along the restraining longitudinal portion of the inner shaft. For example, the inner shaft may be shaped so as to define a longitudinal slit along the restraining longitudinal portion. For some applications, the conduit is shaped so as to define (a) a first opening at a first longitudinal border between the first enclosed longitudinal segment and the restraining longitudinal portion of the inner shaft, and (b) a second opening at a second longitudinal border between the second enclosed longitudinal segment and the restraining longitudinal portion of the inner shaft. The deployment system is configured such that when the restraining wire is removably disposed in the first and the second enclosed longitudinal segments, the restraining wire passes through the first and the second openings.
For some applications, the deployment system further comprises first and second rings. The first ring is longitudinally fixed to and surrounds the inner shaft at a first longitudinal border between the first enclosed longitudinal segment and the restraining longitudinal portion of the inner shaft, and the second ring is longitudinally fixed to and surrounds the inner shaft at a second longitudinal border between the second enclosed longitudinal segment and the restraining longitudinal portion of the inner shaft. The rings typically prevent the inner shaft from being damaged by the restraining wire, which may be strong and thin. The inner shaft may comprise a polymer, which might be torn by the restraining wire in the absence of the rings. For some applications, the rings comprise a radiopaque metal, such as tantalum. The radiopaque material enables the surgeon to visualize the ends of the restraining longitudinal portion during an implantation procedure, which may aid in the proper positioning of the inner shaft and the stent-graft during the procedure.
For some applications, the inner shaft is shaped so as to define a plurality of conduits therealong. For some applications, the plurality of conduits are circumferentially evenly distributed around the inner shaft. The conduits are shaped so as to define respective first enclosed longitudinal segments and respective second enclosed longitudinal segments. Typically, the first enclosed longitudinal segments longitudinally coincide with one another, and the second enclosed longitudinal segments longitudinally coincide with one another. The deployment system comprises a plurality of restraining wires, which are deployed in respective corresponding first and second longitudinal segments, typically such that a single one of the wires is removably disposed in each of the first longitudinal segments and corresponding second longitudinal segment. Providing a separate conduit for each of the restraining wires generally prevents the wires from becoming entangled with one another, or pulling on one another, particularly when the delivery shaft is advanced along a tortuous path through the subject's vasculature.
For some applications, the deployment system is configured to restrain more than one longitudinal portion of the stent-graft, such as two, three, four, or more longitudinal portions.
In some applications of the present invention, the deployment system comprises:
In some applications of the present invention, the restraining wires comprise at least first and second restraining wires, which physically engage respective longitudinal portions of the stent-graft, thereby preventing full radial expansion of the longitudinal portions. The control handle comprises a first withdrawal actuator to which a proximal portion of the first restraining wire is coupled, and a second withdrawal actuator to which a proximal portion of the second restraining wire is coupled. The first and second withdrawal actuators are configured to withdraw the first and second restraining wires, respectively, in a proximal direction.
There is therefore provided, in accordance with an application of the present invention, apparatus comprising:
For some applications, the restraining longitudinal portion of the inner shaft has a length equal to at least 15% of a perimeter of the inner shaft. Alternatively or additionally, for some applications, the length is less than 150% of the perimeter. For some applications, the restraining longitudinal portion of the inner shaft has a length equal to less than 15% of a perimeter of the longitudinal portion of the stent-graft when the stent-graft is unconstrained in a fully radially-expanded state, such as less than 5% of the perimeter.
For some applications, the restraining longitudinal portion of the inner shaft has a length of less than 20 mm, such as less than 10 mm, e.g., less than 5 mm. Alternatively or additionally, for some applications, the restraining longitudinal portion of the inner shaft has a length equal to less than 150% of a perimeter of the inner shaft, such as less than 100% of the perimeter. Alternatively or additionally, for some applications, the inner shaft has an outer diameter of no more than 4 mm, such as no more than 3 mm. Alternatively or additionally, for some applications, the length of at least one of the first and the second enclosed longitudinal segments is at least 30 mm. Alternatively or additionally, for some applications, the restraining wire has a diameter of between 0.08 and 0.3 mm.
For some applications, the restraining wire has at least one property selected from the group consisting of: a stiffness of at least 0.0002 Mm4, and a Young's modulus of at least 60 GPa.
For some applications, the first enclosed longitudinal segment is distal to the second enclosed longitudinal segment, the restraining wire terminates at a free distal end thereof, and the deployment system is configured such that, when the restraining wire is removably disposed in the first and the second enclosed longitudinal segments, the free distal end of the restraining wire is disposed at a location selected from the group consisting of: a location within the first enclosed longitudinal segment, and a location distally beyond the first enclosed longitudinal segment.
For some applications, the stent-graft includes a generally tubular support element, which includes a plurality of structural stent elements; and when the restraining wire is removably disposed in the first and the second enclosed longitudinal segments, the portion of the restraining wire disposed alongside the restraining longitudinal portion of the inner shaft prevents the full radial expansion of the longitudinal portion of the stent-graft by physically engaging at least one of the structural stent elements of the longitudinal portion of the stent-graft.
For some applications, the stent-graft includes a generally tubular support element, and a covering element that is attached to and at least partially covers the support element; and when the restraining wire is removably disposed in the first and the second enclosed longitudinal segments, the portion of the restraining wire disposed alongside the restraining longitudinal portion of the inner shaft prevents the full radial expansion of the longitudinal portion of the stent-graft by physically engaging the covering element at the longitudinal portion of the stent-graft.
For any of the applications described above, the deployment system may be configured such that when the restraining wire is removably disposed in the first and the second enclosed longitudinal segments, the portion of the restraining wire disposed alongside the restraining longitudinal portion of the inner shaft extends outward from the inner shaft. For some applications, the deployment system is configured such that a greatest distance of the restraining wire from an external surface of the inner shaft is no more than 1 mm, when the portion of the restraining wire disposed alongside the restraining longitudinal portion engages the longitudinal portion of the stent-graft, and the stent-graft is not otherwise constrained.
For any of the applications described above, the conduit may be open along the restraining longitudinal portion of the inner shaft. For some applications, the inner shaft is shaped so as to define a longitudinal slit along the restraining longitudinal portion, such that the conduit is open along the restraining longitudinal portion.
For any of the applications described above, the conduit may be shaped so as to define (a) a first opening at a first longitudinal border between the first enclosed longitudinal segment and the restraining longitudinal portion of the inner shaft, and (b) a second opening at a second longitudinal border between the second enclosed longitudinal segment and the restraining longitudinal portion of the inner shaft; and the deployment system may be configured such that when the restraining wire is removably disposed in the first and the second enclosed longitudinal segments, the restraining wire passes through the first and the second openings. For some applications, the deployment system is configured such that when the restraining wire is removably disposed in the first and the second enclosed longitudinal segments, the portion of the restraining wire disposed alongside the restraining longitudinal portion of the inner shaft, longitudinally between the first and the second openings, extends outward from the inner shaft.
For any of the applications described above, the deployment system may further include an outer sheath, which is sized to hold the stent-graft in a first radially-compressed state when the stent-graft is disposed in the outer sheath; and when the restraining wire is removably disposed in the first and the second enclosed longitudinal segments, and the outer sheath has been withdrawn from the longitudinal portion of the stent-graft, the portion of the restraining wire disposed alongside the restraining longitudinal portion of the inner shaft prevents the full radial expansion of the longitudinal portion of the stent-graft, and allows partial radial expansion of the longitudinal portion of the stent-graft to a second radially-compressed state in which the longitudinal portion of the stent-graft is less radially compressed than in the first radially-compressed state.
For any of the applications described above, the deployment system may further include: a first ring, which is longitudinally fixed to and surrounds the inner shaft at a first longitudinal border between the first enclosed longitudinal segment and the restraining longitudinal portion of the inner shaft; and a second ring, which is longitudinally fixed to and surrounds the inner shaft at a second longitudinal border between the second enclosed longitudinal segment and the restraining longitudinal portion of the inner shaft. For some applications, the first and the second rings include a radiopaque metal.
For any of the applications described above, the apparatus may be for use with a guidewire, and the inner shaft may be shaped so as to further define a bore therethrough, which is sized for passage of the guidewire therethrough. For some applications, the bore is concentrically disposed in the inner shaft.
For any of the applications described above:
For some applications, the plurality of conduits are circumferentially evenly distributed around the inner shaft. For some applications, the apparatus is for use with a guidewire, and the inner shaft is shaped so as to further define a bore therethrough, which is sized for passage of the guidewire therethrough. For some applications, the bore is concentrically disposed in the inner shaft. For some applications, the plurality of conduits are circumferentially evenly distributed around the bore.
For some applications, each of the restraining wires has at least one property selected from the group consisting of: a stiffness of at least 0.0002 Mm4, and a Young's modulus of at least 60 GPa.
For some applications, the first enclosed longitudinal segments are distal to the second enclosed longitudinal segments, the restraining wires terminate at respective free distal ends thereof, and the deployment system is configured such that, when the restraining wires are removably disposed in the first enclosed longitudinal segments, respectively, and in the second enclosed longitudinal segments, respectively, the free distal ends of the restraining wires are disposed at respective locations, each of which is selected from the group consisting of: a location within the respective one of the first enclosed longitudinal segments, and a location distally beyond the respective one of the first enclosed longitudinal segments.
For any of the applications described above:
For some applications, a longitudinal distance between longitudinally-closest ends of the first and the second longitudinal portions of the stent-graft equals at least 10% of an average of (a) a perimeter of the first longitudinal portion and (b) a perimeter of the second longitudinal portion, when the stent-graft is unconstrained in a fully radially-expanded state. Alternatively or additionally, for some applications, a longitudinal distance between longitudinally-closest ends of the first and the second longitudinal portions of the stent-graft is at least 10 mm.
For any of the applications described above:
For any of the applications described above, the deployment system may further include a control handle, which is coupled to a proximal portion of the inner shaft, and which includes a withdrawal actuator to which a proximal portion of the restraining wire is coupled, and the withdrawal actuator may be configured to withdraw the restraining wire in a proximal direction, thereby withdrawing the restraining wire from at least the first enclosed longitudinal segment, and releasing and allowing radial expansion of the longitudinal portion of the stent-graft. For some applications, the withdrawal actuator includes a spool to which the proximal portion of the restraining wire is coupled, and the spool is arranged such that rotation thereof withdraws the restraining wire in the proximal direction.
For any of the applications described above, the stent-graft may be shaped so as to define one or more lateral fenestrations. For some applications, the apparatus further includes one or more branching stent-grafts, which are configured to form respective blood-tight seals with the one or more lateral fenestrations, respectively.
There is further provided, in accordance with an application of the present invention, apparatus including:
The apparatus may implement any of the features described hereinabove.
For some applications, the length of the restraining longitudinal portion is less than 150% of the perimeter of the inner shaft.
For some applications, the first enclosed longitudinal segment is distal to the second enclosed longitudinal segment, the restraining wire terminates at a free distal end thereof, and the deployment system is configured such that, when the restraining wire is removably disposed in the first and the second enclosed longitudinal segments, the free distal end of the restraining wire is disposed at a location selected from the group consisting of: a location within the first enclosed longitudinal segment, and a location distally beyond the first enclosed longitudinal segment.
For some applications, the restraining wire has at least one property selected from the group consisting of: a stiffness of at least 0.0002 Mm4, and a Young's modulus of at least 60 GPa.
There is still further provided, in accordance with an application of the present invention, apparatus including:
The apparatus may implement any of the features described hereinabove.
For some applications, the first enclosed longitudinal segments are distal to the second enclosed longitudinal segments, and the deployment system is configured such that, when the restraining wires are removably disposed in the first enclosed longitudinal segments, respectively, and in the second enclosed longitudinal segments, respectively, the free distal ends of the restraining wires are disposed at respective locations, each of which is selected from the group consisting of: a location within the respective one of the first enclosed longitudinal segments, and a location distally beyond the respective one of the first enclosed longitudinal segments.
For some applications, the restraining wire has at least one property selected from the group consisting of: a stiffness of at least 0.0002 Mm4, and a Young's modulus of at least 60 GPa.
There is additionally provided, in accordance with an application of the present invention, apparatus including:
The apparatus may implement any of the features described hereinabove.
For some applications, a length of the restraining longitudinal portion is less than 150% of a perimeter of the inner shaft.
For some applications, the restraining wire has at least one property selected from the group consisting of: a stiffness of at least 0.0002 Mm4, and a Young's modulus of at least 60 GPa.
There is yet additionally provided, in accordance with an application of the present invention, apparatus including:
For some applications, the one or more conduits include a plurality of conduits, and the one or more restraining wires include a plurality of restraining wires. For some applications, the conduits are at least partially removably disposed in respective ones of the conduits.
For some applications, the restraining wires terminate at respective free distal ends thereof.
For some applications, each of the restraining wires has at least one property selected from the group consisting of: a stiffness of at least 0.0002 Mm4, and a Young's modulus of at least 60 GPa.
Alternatively or additionally, the apparatus may implement any of the features described hereinabove.
There is also provided, in accordance with an application of the present invention, apparatus including:
For some applications, the deployment system (a) further include an inner shaft, which is removably disposed in the stent-graft, and which has non-longitudinally-overlapping first and second restraining longitudinal portions, and (b) is configured such that:
when a first portion of the first restraining wire is disposed alongside the first restraining longitudinal portion of the inner shaft, the first portion of the first restraining wire prevents the full radial expansion of the first longitudinal portion of the stent-graft by physically engaging the first longitudinal portion of the stent-graft,
when a second portion of the second restraining wire is disposed alongside the second restraining longitudinal portion of the inner shaft, the second portion of the second restraining wire prevents the full radial expansion of the second longitudinal portion of the stent-graft by physically engaging the second longitudinal portion of the stent-graft,
when the first restraining wire has been at least partially withdrawn from alongside the first restraining longitudinal portion of the inner shaft, the first restraining wire does not prevent the full radial expansion of the first longitudinal portion of the stent-graft, and
when the second restraining wire has been at least partially withdrawn from alongside the second restraining longitudinal portion of the inner shaft, the second restraining wire does not prevent the full radial expansion of the second longitudinal portion of the stent-graft.
For some applications, the first and the second restraining wires terminate at respective free distal ends thereof.
For some applications, each of the first and the second restraining wires has at least one property selected from the group consisting of: a stiffness of at least 0.0002 Mm4, and a Young's modulus of at least 60 GPa.
For some applications, a longitudinal distance between longitudinally-closest ends of the first and the second longitudinal portions of the stent-graft equals at least 10% of an average of (a) a perimeter of the first longitudinal portion and (b) a perimeter of the second longitudinal portion, when the stent-graft is unconstrained in a fully radially-expanded state. Alternatively or additionally, for some applications, a longitudinal distance between longitudinally-closest ends of the first and the second longitudinal portions of the stent-graft is at least 10 mm.
For some applications:
the second restraining wire physically engages a third longitudinal portion of the stent-graft, thereby preventing full radial expansion of the third longitudinal portion,
the first restraining wire does not engage the third longitudinal portion of the stent-graft, and
the third longitudinal portion does not longitudinally overlap the first or the second longitudinal portions, and the first restraining longitudinal portion is longitudinally disposed between the second and the third longitudinal portions.
For some applications, the stent-graft includes a generally tubular support element, which includes a plurality of structural stent elements; and the first restraining wire physically engages at least one of the structural stent elements of the first longitudinal portion of the stent-graft.
For some applications, the stent-graft includes a generally tubular support element, and a covering element that is attached to and at least partially covers the support element; and the first restraining wire physically engages the covering element at the first longitudinal portion of the stent-graft.
For any of the applications described above, the deployment system may further include a control handle, which includes:
a first withdrawal actuator to which a proximal portion of the first restraining wire is coupled, and the first withdrawal actuator is configured to withdraw the first restraining wire in a proximal direction; and
a second withdrawal actuator to which a proximal portion of the second restraining wire is coupled, and the second withdrawal actuator is configured to withdraw the second restraining wire in the proximal direction.
For some applications:
the first withdrawal actuator includes a first spool to which the proximal portion of the first restraining wire is coupled, and the first spool is arranged such that rotation thereof withdraws the first restraining wire in the proximal direction, and
the second withdrawal actuator includes a second spool to which the proximal portion of the second restraining wire is coupled, and the second spool is arranged such that rotation thereof withdraws the second restraining wire in the proximal direction.
For any of the applications described above, the stent-graft may be shaped so as to define one or more lateral fenestrations. For some applications, the apparatus further includes one or more branching stent-grafts, which are configured to form respective blood-tight seals with the one or more lateral fenestrations, respectively.
There is further provided, in accordance with an application of the present invention, apparatus including a deployment system, which includes:
For some applications, a longitudinal distance between longitudinally-closest ends of the first and the second non-enclosed longitudinal segments is at least 10 mm.
For some applications, the first and the second restraining wires terminate at respective free distal ends thereof.
For some applications, each of the first and the second restraining wires has at least one property selected from the group consisting of: a stiffness of at least 0.0002 Mm4, and a Young's modulus of at least 60 GPa.
For some applications, the apparatus further includes a self-expanding stent-graft, and the deployment system is configured such that:
when a first portion of the first restraining wire is disposed alongside the first non-enclosed longitudinal portion of the inner shaft, the first portion of the first restraining wire prevents full radial expansion of a first longitudinal portion of the stent-graft by physically engaging the first longitudinal portion of the stent-graft,
when a second portion of the second restraining wire is disposed alongside the second non-enclosed longitudinal portion of the inner shaft, the second portion of the second restraining wire prevents full radial expansion of a second longitudinal portion of the stent-graft by physically engaging the second longitudinal portion of the stent-graft,
when the first restraining wire has been at least partially withdrawn from alongside the first non-enclosed longitudinal portion of the inner shaft, the first restraining wire does not prevent the full radial expansion of the first longitudinal portion of the stent-graft, and
when the second restraining wire has been at least partially withdrawn from alongside the second non-enclosed longitudinal portion of the inner shaft, the second restraining wire does not prevent the full radial expansion of the second longitudinal portion of the stent-graft.
For any of the applications described above, the deployment system may further include a control handle, which includes:
a first withdrawal actuator to which a proximal portion of the first restraining wire is coupled, and the first withdrawal actuator is configured to withdraw the first restraining wire in a proximal direction; and
a second withdrawal actuator to which a proximal portion of the second restraining wire is coupled, and the second withdrawal actuator is configured to withdraw the second restraining wire in the proximal direction.
For some applications, the first withdrawal actuator includes a first spool to which the proximal portion of the first restraining wire is coupled, and the first spool is arranged such that rotation thereof withdraws the first restraining wire in the proximal direction; and the second withdrawal actuator includes a second spool to which the proximal portion of the second restraining wire is coupled, and the second spool is arranged such that rotation thereof withdraws the second restraining wire in the proximal direction.
There is still further provided, in accordance with an application of the present invention, apparatus including:
For some applications:
the first withdrawal actuator includes a first spool to which the proximal portion of the first restraining wire is coupled, and the first spool is arranged such that rotation thereof withdraws the first restraining wire in the proximal direction, and
the second withdrawal actuator includes a second spool to which the proximal portion of the second restraining wire is coupled, and the second spool is arranged such that rotation thereof withdraws the second restraining wire in the proximal direction.
For some applications, the first and the second restraining wires terminate at respective free distal ends thereof.
For some applications, each of the first and the second restraining wires has at least one property selected from the group consisting of: a stiffness of at least 0.0002 Mm4, and a Young's modulus of at least 60 GPa.
There is additionally provided, in accordance with an application of the present invention, apparatus including:
For some applications, the first and the second restraining wires terminate at respective free distal ends thereof.
For some applications, each of the first and the second restraining wires has at least one property selected from the group consisting of: a stiffness of at least 0.0002 Mm4, and a Young's modulus of at least 60 GPa.
There is yet additionally provided, in accordance with an application of the present invention, a method including:
advancing an inner shaft of a deployment system through a body lumen of a subject, while the inner shaft is removably disposed in a self-expanding stent-graft, wherein the inner shaft is shaped so as to define (a) at least one conduit therealong, which conduit is (i) not coaxial with the inner shaft, and (ii) shaped so as to define at least first and second enclosed longitudinal segments, each of which has a length of at least 30 mm, and (b) a restraining longitudinal portion that is longitudinally disposed between the first and the second enclosed longitudinal segments, wherein advancing includes advancing the inner shaft while a restraining wire of the deployment system is removably disposed in the first and the second enclosed longitudinal segments, and a portion of the restraining wire disposed alongside the restraining longitudinal portion of the inner shaft prevents full radial expansion of a longitudinal portion of the stent-graft by physically engaging the longitudinal portion of the stent-graft; and
withdrawing the restraining wire from at least the first enclosed longitudinal segment, such that the restraining wire does not prevent the full radial expansion of the longitudinal portion of the stent-graft.
For some applications, the restraining longitudinal portion of the inner shaft has a length equal to at least 15% of a perimeter of the inner shaft. Alternatively or additionally, for some applications, the length is less than 150% of the perimeter. For some applications, the restraining longitudinal portion of the inner shaft has a length equal to less than 15% of a perimeter of the longitudinal portion of the stent-graft when the stent-graft is unconstrained in a fully radially-expanded state, such as less than 5% of the perimeter. For some applications, the restraining longitudinal portion of the inner shaft has a length of less than 20 mm. For some applications, the length is less than 10 mm, such as less than 5 mm. For some applications, the restraining longitudinal portion of the inner shaft has a length equal to less than 150% of a perimeter of the inner shaft, such as less than 100% of the perimeter. For some applications, the inner shaft has an outer diameter of no more than 4 mm. For some applications, each of the first and the second enclosed longitudinal segments has an inner diameter of no more than 3 mm.
For some applications, withdrawing the restraining wire comprises withdrawing the restraining wire in a proximal direction, and advancing the inner shaft comprises applying no tensile force or less than 10 N of tensile force to a proximal portion of the restraining wire while advancing the inner shaft.
For some applications, advancing includes advancing the inner shaft while the restraining wire is removably disposed in the first and the second enclosed longitudinal segments, such that the portion of the restraining wire disposed alongside the restraining longitudinal portion of the inner shaft extends outward from the inner shaft. For some applications, advancing includes advancing the inner shaft while a greatest distance of the restraining wire from an external surface of the inner shaft is no more than 1 mm.
For some applications, the length of at least one of the first and the second enclosed longitudinal segments is at least 30 mm.
For some applications, the restraining wire has a diameter of between 0.08 and 0.3 mm.
For some applications, the restraining wire has at least one property selected from the group consisting of: a stiffness of at least 0.0002 Mm4, and a Young's modulus of at least 60 GPa.
For some applications, the first enclosed longitudinal segment is distal to the second enclosed longitudinal segment, the restraining wire terminates at a free distal end thereof, and advancing comprises advancing the inner shaft while the restraining wire is removably disposed in the first and the second enclosed longitudinal segments, and the free distal end of the restraining wire is disposed at a location selected from the group consisting of: a location within the first enclosed longitudinal segment, and a location distally beyond the first enclosed longitudinal segment.
For some applications, the stent-graft includes a generally tubular support element, which includes a plurality of structural stent elements; and advancing includes advancing the inner shaft while the restraining wire is removably disposed in the first and the second enclosed longitudinal segments, and the portion of the restraining wire disposed alongside the restraining longitudinal portion of the inner shaft prevents the full radial expansion of the longitudinal portion of the stent-graft by physically engaging at least one of the structural stent elements of the longitudinal portion of the stent-graft.
For some applications, the stent-graft includes a generally tubular support element, and a covering element that is attached to and at least partially covers the support element; and advancing includes advancing the inner shaft while the restraining wire is removably disposed in the first and the second enclosed longitudinal segments, and the portion of the restraining wire disposed alongside the restraining longitudinal portion of the inner shaft prevents the full radial expansion of the longitudinal portion of the stent-graft by physically engaging the covering element at the longitudinal portion of the stent-graft.
For some applications, the conduit is open along the restraining longitudinal portion of the inner shaft. For some applications, the inner shaft is shaped so as to define a longitudinal slit along the restraining longitudinal portion, such that the conduit is open along the restraining longitudinal portion.
For some applications, the conduit is shaped so as to define (a) a first opening at a first longitudinal border between the first enclosed longitudinal segment and the restraining longitudinal portion of the inner shaft, and (b) a second opening at a second longitudinal border between the second enclosed longitudinal segment and the restraining longitudinal portion of the inner shaft; and the deployment system is configured such that when the restraining wire is removably disposed in the first and the second enclosed longitudinal segments, the restraining wire passes through the first and the second openings. For some applications, advancing includes advancing the inner shaft while the portion of the restraining wire disposed alongside the restraining longitudinal portion of the inner shaft, longitudinally between the first and the second openings, extends outward from the inner shaft.
For some applications, advancing includes advancing the inner shaft while the stent-graft is disposed in an outer sheath of the deployment system, which outer sheath holds the stent-graft in a first radially-compressed state; and the method further includes, before withdrawing the restraining wire from at least the first enclosed longitudinal segment, withdrawing the outer sheath from the longitudinal portion of the stent-graft, such that the portion of the restraining wire disposed alongside the restraining longitudinal portion of the inner shaft prevents the full radial expansion of the longitudinal portion of the stent-graft, and allows partial radial expansion of the longitudinal portion of the stent-graft to a second radially-compressed state in which the longitudinal portion of the stent-graft is less radially compressed than in the first radially-compressed state.
For some applications, the deployment system further includes a first ring, which is longitudinally fixed to and surrounds the inner shaft at a first longitudinal border between the first enclosed longitudinal segment and the restraining longitudinal portion of the inner shaft; and a second ring, which is longitudinally fixed to and surrounds the inner shaft at a second longitudinal border between the second enclosed longitudinal segment and the restraining longitudinal portion of the inner shaft. For some applications, the first and the second rings include a radiopaque metal.
For some applications, the inner shaft is shaped so as to further define a bore therethrough, which is sized for passage of a guidewire therethrough; the method further includes, before advancing the inner shaft through the body lumen, advancing the guidewire through the body lumen; and advancing the inner shaft includes advancing the inner shaft over the guidewire, while the guidewire passes through the bore. For some applications, the bore is concentrically disposed in the inner shaft.
For some applications:
the inner shaft is shaped so as to define a plurality of conduits therealong, which conduits are shaped so as to define respective first enclosed longitudinal segments and respective second enclosed longitudinal segments,
the first enclosed longitudinal segments longitudinally coincide with one another,
the second enclosed longitudinal segments longitudinally coincide with one another,
the restraining longitudinal portion of the inner shaft is longitudinally disposed between (a) the first enclosed longitudinal segments and (b) the second enclosed longitudinal segments,
the deployment system includes a plurality of restraining wires,
advancing includes advancing the inner shaft while the restraining wires are removably disposed in the first enclosed longitudinal segments, respectively, and in the second enclosed longitudinal segments, respectively, and respective portions of the restraining wires disposed alongside the restraining longitudinal portion of the inner shaft prevent the full radial expansion of the longitudinal portion of the stent-graft by physically engaging the longitudinal portion of the stent-graft, and
withdrawing the restraining wire includes withdrawing the restraining wires from at least the first enclosed longitudinal segments, respectively, such that the restraining wires do not prevent the full radial expansion of the longitudinal portion of the stent-graft.
For some applications, the plurality of conduits are circumferentially evenly distributed around the inner shaft.
For some applications, the inner shaft is shaped so as to further define a bore therethrough, which is sized for passage of a guidewire therethrough; the method further includes, before advancing the inner shaft through the body lumen, advancing the guidewire through the body lumen; and advancing the inner shaft includes advancing the inner shaft over the guidewire, while the guidewire passes through the bore. For some applications, the bore is concentrically disposed in the inner shaft. For some applications, the plurality of conduits are circumferentially evenly distributed around the bore.
For some applications, each of the restraining wires has at least one property selected from the group consisting of: a stiffness of at least 0.0002 Mm4, and a Young's modulus of at least 60 GPa.
For some applications, the first enclosed longitudinal segments are distal to the second enclosed longitudinal segments, the restraining wires terminate at respective free distal ends thereof, and advancing comprises advancing the inner shaft while the restraining wires are removably disposed in the first enclosed longitudinal segments, respectively, and in the second enclosed longitudinal segments, respectively, and the free distal ends of the restraining wires are disposed at respective locations, each of which is selected from the group consisting of: a location within the respective one of the first enclosed longitudinal segments, and a location distally beyond the respective one of the first enclosed longitudinal segments.
For some applications:
the at least one conduit is at least one first conduit, the at least one restraining wire is at least one first restraining wire, the restraining longitudinal portion of the inner shaft is a first restraining longitudinal portion, and the longitudinal portion of the stent-graft is a first longitudinal portion of the stent-graft,
the inner shaft is shaped so as to define (a) at least one second conduit therealong, which second conduit is shaped so as to define third and fourth enclosed longitudinal segments, and (b) a second restraining longitudinal portion that is longitudinally disposed between the third and the fourth enclosed longitudinal segments, and does not longitudinally overlap the first restraining longitudinal portion,
the deployment system further includes at least one second restraining wire,
advancing includes advancing the inner shaft while the second restraining wire is removably disposed in the third and the fourth enclosed longitudinal segments, and a portion of the second restraining wire disposed alongside the second restraining longitudinal portion of the inner shaft prevents full radial expansion of a second longitudinal portion of the stent-graft by physically engaging the second longitudinal portion of the stent-graft,
the method further includes withdrawing the second restraining wire from at least the third enclosed longitudinal segment, such that the second restraining wire does not prevent the full radial expansion of the second longitudinal portion of the stent-graft,
the first restraining wire does not engage the second longitudinal portion of the stent-graft, and
the second restraining wire does not engage the first longitudinal portion of the stent-graft.
For some applications, a longitudinal distance between longitudinally-closest ends of the first and the second longitudinal portions of the stent-graft equals at least 10% of an average of (a) a perimeter of the first longitudinal portion and (b) a perimeter of the second longitudinal portion, when the stent-graft is unconstrained in a fully radially-expanded state. Alternatively or additionally, for some applications, a longitudinal distance between longitudinally-closest ends of the first and the second longitudinal portions of the stent-graft is at least 10 mm.
For some applications:
the restraining longitudinal portion of the inner shaft is a first restraining longitudinal portion, the portion of the restraining wire disposed alongside the first restraining longitudinal portion of the inner shaft is a first portion of the restraining wire, and the longitudinal portion of the stent-graft is a first longitudinal portion of the stent-graft,
the conduit is shaped so as to further define (a) a third enclosed longitudinal segment, which does not longitudinally overlap the first enclosed longitudinal segment or the second enclosed longitudinal segment, and (b) a second restraining longitudinal portion that is longitudinally disposed between the second and the third enclosed longitudinal segments,
advancing includes advancing the inner shaft while the restraining wire is removably disposed in the first, the second, and the third enclosed longitudinal segments, and a second portion of the restraining wire disposed alongside the second restraining longitudinal portion of the inner shaft prevents full radial expansion of a second longitudinal portion of the stent-graft by physically engaging the second longitudinal portion of the stent-graft, and
the method further includes withdrawing the restraining wire from at least the second enclosed longitudinal segment, such that the restraining wire does not prevent the full radial expansion of the second longitudinal portion of the stent-graft.
For some applications, the deployment system further includes a control handle, which is coupled to a proximal portion of the inner shaft, and which includes a withdrawal actuator to which a proximal portion of the restraining wire is coupled; and withdrawing the restraining wire includes actuating the withdrawal actuator to withdraw the restraining wire in a proximal direction, thereby withdrawing the restraining wire from at least the first enclosed longitudinal segment, and releasing and allowing radial expansion of the longitudinal portion of the stent-graft. For some applications, the withdrawal actuator includes a spool to which the proximal portion of the restraining wire is coupled, and actuating the withdrawal actuator includes rotating the spool to withdraw the restraining wire in the proximal direction.
For some applications, the stent-graft is shaped so as to define one or more lateral fenestrations. For some applications, the method further includes advancing one or more branching stent-grafts into respective branching blood body lumen that branch from the body lumen; and radially expanding the one or more branching stent-grafts so that the branching stent-grafts form respective blood-tight seals with the one or more lateral fenestrations, respectively.
There is also provided, in accordance with an application of the present invention, a method including:
advancing an inner shaft of a deployment system through a body lumen of a subject, while the inner shaft is removably disposed in a self-expanding stent-graft, wherein the inner shaft is shaped so as to define one or more conduits therealong, which conduits are not coaxial with the inner shaft, wherein advancing includes advancing the inner shaft while one or more restraining wires of the deployment system are at least partially removably disposed in conduits, and prevent full radial expansion of one or more longitudinal portions of the stent-graft by physically engaging the one or more longitudinal portions of the stent-graft; and
at least partially withdrawing the one or more restraining wires, such that the one or more restraining wires do not prevent the full radial expansion of the one or more longitudinal portions of the stent-graft.
For some applications, the one or more conduits include a plurality of conduits, and the one or more restraining wires include a plurality of restraining wires. For some applications, advancing includes advancing the inner shaft while the conduits are at least partially removably disposed in respective ones of the conduits.
For some applications, withdrawing the one or more restraining wires comprises withdrawing the one or more restraining wires in a proximal direction, and advancing the inner shaft comprises applying no tensile force or less than 10 N of tensile force to respective proximal portions of the one or more restraining wires while advancing the inner shaft.
For some applications, the restraining wires terminate at respective free distal ends thereof.
For some applications, each of the restraining wires has at least one property selected from the group consisting of: a stiffness of at least 0.0002 Mm4, and a Young's modulus of at least 60 GPa.
There is further provided, in accordance with an application of the present invention, a method including:
advancing an inner shaft of a deployment system through a body lumen of a subject, while the inner shaft is removably disposed in a self-expanding stent-graft, and while a plurality of restraining wires of the deployment system physically engage the stent-graft and prevent full radial expansion of at least a portion of the stent-graft;
at least partially withdrawing a first subset of the restraining wires, which first subset includes at least a first one of the restraining wires; and
after at least partially withdrawing the first subset of the restraining wires, at least partially withdrawing a second subset of the restraining wires, which second subset is different from the first subset and includes at least a second one of the restraining wires.
For some applications, at least partially withdrawing the second subset includes beginning at least partially withdrawing the second subset at least one second after at least partially withdrawing the first subset.
For some applications, withdrawing the first and the second subsets of the restraining wires comprises withdrawing the first and the second subsets of the restraining wires in a proximal direction, and advancing the inner shaft comprises applying no tensile force or less than 10 N of tensile force to respective proximal portions of the plurality of restraining wires while advancing the inner shaft.
For some applications, the restraining wires terminate at respective free distal ends thereof.
For some applications, each of the restraining wires has at least one property selected from the group consisting of: a stiffness of at least 0.0002 Mm4, and a Young's modulus of at least 60 GPa.
For some applications, advancing includes advancing the inner shaft while:
the first one of the restraining wires (a) physically engages a first longitudinal portion of the stent-graft, thereby preventing full radial expansion of the first longitudinal portion, and (b) does not engage a second longitudinal portion of the stent-graft, which second longitudinal portion does not longitudinally overlap the first longitudinal portion, and
the second one of the restraining wires (a) physically engages the second longitudinal portion of the stent-graft, thereby preventing full radial expansion of the second longitudinal portion, and (b) does not engage the first longitudinal portion of the stent-graft.
For some applications:
the deployment system further includes a control handle, which includes (a) a first withdrawal actuator, to which a proximal portion of the first subset of the restraining wires is coupled, and (b) a second withdrawal actuator, to which a proximal portion of the second subset of the restraining wires is coupled,
at least partially withdrawing the first subset includes actuating the first withdrawal actuator to at least partially withdraw the first subset in a proximal direction, and
at least partially withdrawing the second subset includes actuating the second withdrawal actuator to at least partially withdraw the second subset in a proximal direction.
For some applications:
the first withdrawal actuator includes a first spool to which the proximal portion of the first subset is coupled,
the second withdrawal actuator includes a second spool to which the proximal portion of the second subset is coupled,
actuating the first withdrawal actuator includes rotating the first spool to at least partially withdraw the first subset in the proximal direction, and
actuating the second withdrawal actuator includes rotating the second spool to at least partially withdraw the second subset in the proximal direction.
For some applications:
the deployment system further includes a control handle, which (a) includes a withdrawal actuator, which includes a spool to which a proximal portion of the first subset of the restraining wires is coupled, and (b) is shaped so as to define one or more lumens open to an external surface of the control handle, through which lumen the second subset of the restraining wires passes,
at least partially withdrawing the first subset includes rotating the spool to at least partially withdraw the first subset in a proximal direction, and
at least partially withdrawing the second subset includes pulling on the second subset of restraining wires from outside the control handle.
For some applications:
the deployment system further includes a control handle, which (a) includes a withdrawal actuator, which includes a spool to which a proximal portion of the second subset of the restraining wires is coupled, and (b) is shaped so as to define one or more lumens open to an external surface of the control handle, through which lumen the first subset of the restraining wires passes,
at least partially withdrawing the first subset includes pulling on the first subset of restraining wires from outside the control handle, and
at least partially withdrawing the second subset includes rotating the spool to at least partially withdraw the second subset in a proximal direction.
There is still further provided, in accordance with an application of the present invention, a method including:
For some applications, advancing includes advancing the inner shaft while the second restraining wire physically engages a third longitudinal portion of the stent-graft, thereby preventing full radial expansion of the third longitudinal portion, and while the first restraining wire does not engage the third longitudinal portion of the stent-graft, and the third longitudinal portion does not longitudinally overlap the first or the second longitudinal portions, and the first restraining longitudinal portion is longitudinally disposed between the second and the third longitudinal portions.
For some applications:
the deployment system further includes a control handle, which includes (a) a first withdrawal actuator to which a proximal portion of the first restraining wire is coupled, and (b) a second withdrawal actuator to which a proximal portion of the second restraining wire is coupled,
at least partially withdrawing the first restraining wire includes actuating the first withdrawal actuator to at least partially withdraw the first restraining wire in a proximal direction, and
at least partially withdrawing the second restraining wire includes actuating the second withdrawal actuator to at least partially withdraw the second restraining wire in the proximal direction.
For some applications:
the first withdrawal actuator includes a first spool to which the proximal portion of the first restraining wire is coupled,
the second withdrawal actuator includes a second spool to which the proximal portion of the second restraining wire is coupled,
actuating the first withdrawal actuator includes rotating the first spool to at least partially withdraw the first restraining wire in the proximal direction, and
actuating the first withdrawal actuator includes rotating the second spool to at least partially withdraw the second restraining wire in the proximal direction.
For some applications, the stent-graft is shaped so as to define one or more lateral fenestrations. For some applications, the method further includes advancing one or more branching stent-grafts into respective branching blood body lumen that branch from the body lumen; and radially expanding the one or more branching stent-grafts so that the branching stent-grafts form respective blood-tight seals with the one or more lateral fenestrations, respectively.
For some applications, withdrawing the first and the second restraining wires comprises withdrawing the first and the second restraining wires in a proximal direction, and advancing the inner shaft comprises applying no tensile force or less than 10 N of tensile force to respective proximal portions of the first and the second restraining wires while advancing the inner shaft.
For some applications, the first and the second restraining wires terminate at respective free distal ends thereof.
For some applications, each of the first and the second restraining wires has at least one property selected from the group consisting of: a stiffness of at least 0.0002 Mm4, and a Young's modulus of at least 60 GPa.
There is additionally provided, in accordance with an application of the present invention, a method including:
providing an inner shaft of a deployment system, which inner shaft is shaped so as to define: (a) at least a first conduit therealong, which is shaped so as to define at least first and second non-longitudinally-overlapping enclosed longitudinal segments, and a first non-enclosed longitudinal portion disposed longitudinally between the first and the second enclosed longitudinal segments, and (b) at least a second conduit therealong, which is shaped so as to define at least third and fourth non-longitudinally-overlapping enclosed longitudinal segments, and a second non-enclosed longitudinal segment disposed longitudinally between the first and the second enclosed longitudinal segments;
advancing the inner shaft through a body lumen of a subject, while (a) at least a first restraining wire is at least partially removably disposed in the first and the second enclosed longitudinal segments, and alongside the first non-enclosed longitudinal portion, and (b) at least a second restraining wire is at least partially removably disposed in the third and the fourth enclosed longitudinal segments, and alongside the second non-enclosed longitudinal portion;
at least partially withdrawing the first restraining wire; and
at least partially withdrawing the second restraining wire,
wherein the first non-enclosed longitudinal portion does not longitudinally overlap the second non-enclosed longitudinal segment,
wherein the first non-enclosed longitudinal portion at least partially longitudinally overlaps one of the third and the fourth enclosed longitudinal segments,
wherein the second non-enclosed longitudinal portion least partially longitudinally overlaps one of the first and the second enclosed longitudinal segments, and
wherein the first and the second conduits are not coaxial with the inner shaft and are not coaxial with each other.
For some applications, a longitudinal distance between longitudinally-closest ends of the first and the second non-enclosed longitudinal segments is at least 10 mm.
For some applications:
For some applications:
the deployment system further includes a control handle, which includes (a) a first withdrawal actuator to which a proximal portion of the first restraining wire is coupled, and (b) a second withdrawal actuator to which a proximal portion of the second restraining wire is coupled,
at least partially withdrawing the first restraining wire includes actuating the first withdrawal actuator to at least partially withdraw the first restraining wire in a proximal direction, and
at least partially withdrawing the second restraining wire includes actuating the second withdrawal actuator to at least partially withdraw the second restraining wire in the proximal direction.
For some applications:
the first withdrawal actuator includes a first spool to which the proximal portion of the first restraining wire is coupled,
the second withdrawal actuator includes a second spool to which the proximal portion of the second restraining wire is coupled,
actuating the first withdrawal actuator includes rotating the first spool to at least partially withdraw the first restraining wire in the proximal direction, and
actuating the first withdrawal actuator includes rotating the second spool to at least partially withdraw the second restraining wire in the proximal direction.
For some applications, withdrawing the first and the second restraining wires comprises withdrawing the first and the second restraining wires in a proximal direction, and advancing the inner shaft comprises applying no tensile force or less than 10 N of tensile force to respective proximal portions of the first and the second restraining wires while advancing the inner shaft.
For some applications, the first and the second restraining wires terminate at respective free distal ends thereof.
For some applications, each of the first and the second restraining wires has at least one property selected from the group consisting of: a stiffness of at least 0.0002 Mm4, and a Young's modulus of at least 60 GPa.
There is yet additionally provided, in accordance with an application of the present invention, a method including:
advancing an inner shaft of a deployment system through a body lumen of a subject, while the inner shaft is removably disposed in a self-expanding stent-graft, and while at least first and second restraining wires of the deployment system physically engage respective longitudinal portions of the stent-graft, thereby preventing full radial expansion of the longitudinal portions;
at least partially withdrawing the first restraining wire in a proximal direction by actuating a first withdrawal actuator of a control handle, to which first withdrawal actuator a proximal portion of the first restraining wire is coupled; and
at least partially withdrawing the second restraining wire in the proximal direction by actuating a second withdrawal actuator of the control handle, to which second withdrawal actuator a proximal portion of the second restraining wire is coupled.
For some applications:
the first withdrawal actuator includes a first spool to which the proximal portion of the first restraining wire is coupled,
the second withdrawal actuator includes a second spool to which the proximal portion of the second restraining wire is coupled,
actuating the first withdrawal actuator includes rotating the first spool to at least partially withdraw the first restraining wire in the proximal direction, and
actuating the first withdrawal actuator includes rotating the second spool to at least partially withdraw the second restraining wire in the proximal direction.
For some applications, withdrawing the first and the second restraining wires comprises withdrawing the first and the second restraining wires in a proximal direction, and advancing the inner shaft comprises applying no tensile force or less than 10 N of tensile force to respective proximal portions of the first and the second restraining wires while advancing the inner shaft.
For some applications, the first and the second restraining wires terminate at respective free distal ends thereof.
For some applications, each of the first and the second restraining wires has at least one property selected from the group consisting of: a stiffness of at least 0.0002 Mm4, and a Young's modulus of at least 60 GPa.
There is also provided, in accordance with an application of the present invention, a method including:
advancing an inner shaft of a deployment system through a body lumen of a subject, while the inner shaft is removably disposed in a self-expanding stent-graft, and while at least first and second restraining wires of the deployment system physically engage respective longitudinal portions of the stent-graft, thereby preventing full radial expansion of the longitudinal portions;
at least partially withdrawing the first restraining wire in a proximal direction by actuating a withdrawal actuator of a control handle, which withdrawal actuator includes a spool to which a proximal portion of the first restraining wire is coupled; and
at least partially withdrawing the second restraining wire in the proximal direction by pulling on the second restraining wire, which passes through a lumen of the control handle, which lumen is open to an external surface of the control handle.
For some applications, withdrawing the first and the second restraining wires comprises withdrawing the first and the second restraining wires in a proximal direction, and advancing the inner shaft comprises applying no tensile force or less than 10 N of tensile force to respective proximal portions of the first and the second restraining wires while advancing the inner shaft.
For some applications, the first and the second restraining wires terminate at respective free distal ends thereof.
For some applications, each of the first and the second restraining wires has at least one property selected from the group consisting of: a stiffness of at least 0.0002 Mm4, and a Young's modulus of at least 60 GPa.
The present invention will be more fully understood from the following detailed description of embodiments thereof, taken together with the drawings, in which:
Reference is made to
Reference is now made to
As labeled in
Reference is made to
For some applications, conduit 50 is not coaxial with inner shaft 36. In other words, the central longitudinal axis 57 of conduit 50 does not coincide with the central longitudinal axis 59 of inner shaft 36. As used in the present application, including in the claims, a “longitudinal central axis” of an elongate structure is the set of all centroids of cross-sectional sections of the structure along the structure. Thus the cross-sectional sections are locally perpendicular to the central longitudinal axis, which runs along the structure. (If the structure is circular in cross-section, the centroids correspond with the centers of the circular cross-sectional sections.) For applications in which restraining longitudinal portion 56 is open, and thus cannot define any centroids in cross-section, the central longitudinal axis of restraining longitudinal portion 56 is defined by extending the central longitudinal axis of adjacent enclosed longitudinal segments 52 and 54 along restraining longitudinal portion 56.
For some applications, as labeled in
For some applications, the inner shaft comprises polymer, such as a PEEK polymer. For some applications, the inner shaft, along with its bores (conduits 50 and guidewire bore 102, described hereinbelow), are manufactured by standard polymer extrusion technologies, using a custom-designed die (usually a disc with accurately machined openings in the shape of the non-bore sections, i.e., the bores' cross sections are masked in the die, so as to extrude no polymer in these portions of the tube). For some applications, the non-enclosed portions of the tube are formed by hand/machine removal of the thin tube's wall, using a scalpel/fine-drill, respectively.
Deployment system 10 further comprises at least one restraining wire 60. Deployment system 10 is configured such that:
Typically, a proximal portion 72 of restraining wire 60 is coupled to a withdrawal actuator 700 of control handle 20, such as described hereinbelow with reference to
Typically, portion 62 of restraining wire 60 physically engages longitudinal portion 70 by passing through (e.g., being threaded through) one or more elements of longitudinal portion 70, as shown by way of example in the blow-up in
Typically, restraining longitudinal portion 56 of inner shaft 36 has a length equal to less than 15% of a perimeter of longitudinal portion 70 of stent-graft 40, such as less than 5% of the perimeter, when the stent-graft is unconstrained in a fully radially-expanded state, i.e., no forces are applied to the stent-graft by deployment system 10 (such as outer sheath 34), walls of a blood vessel, or otherwise (including that no forces are applied to longitudinally-adjacent portions of the stent-graft, which forces would reduce the perimeter of longitudinal portion 70). Alternatively or additionally, for some applications, restraining longitudinal portion 56 of inner shaft 36 has a length of less than 20 mm, such as less than 10 mm, e.g., less than 5 mm. Alternatively or additionally, for some applications, restraining longitudinal portion 56 of inner shaft 36 has a length that is less than 150% of a perimeter of inner shaft 36, such as less than 100% of the perimeter, e.g., less than 50% of the perimeter (the perimeter is the circumference in configurations in which the inner shaft is circular in cross-section). Typically, the length of restraining longitudinal portion 56 is at least 15% of the perimeter of inner shaft 36, such as at least 30% of the perimeter. Alternatively or additionally, the length of restraining longitudinal portion 56 may be at least 1.5 mm, such as 3 mm. Typically, each of first and second enclosed longitudinal segments 52 and 54 has an inner diameter of no more than 3 mm, such as no more than 2, and/or of no more than 50% of the outer diameter of inner shaft 36, such as no more than 30% of the outer diameter.
Upon withdrawal of outer sheath 34, the radially-compressed self-expanding stent-graft's outwardly-directed radial force, at certain locations along and around the stent-graft, is now applied to restraining wire 60. The exposed portion of the restraining wire is short enough relative to its cross section, and hence is stiff enough, so as to act more like a restraining beam than a suturing filament. Therefore, the outwardly-directed radial force does not pull out the portion of restraining wire 60 disposed in first enclosed longitudinal segment 52, even though distal end 74 of restraining wire 60 is not fixed to delivery shaft 30, as mentioned above. The relatively small inner diameter of first and second enclosed longitudinal segments 52 and 54 also generally helps prevent restraining wire 60 from being prematurely pulled out of first enclosed longitudinal segment 52. The relatively short length of restraining longitudinal portion 56 enables restraining wire 60 to perform its restraining function, even though restraining wire 60 is still flexible enough to accommodate a tortuous path through the subject's vasculature during advancing of delivery shaft 30. In other words, if restraining longitudinal portion 56 were longer, restraining wire 60 would need to be so stiff that the restraining wire could not accommodate the tortuous path of the vasculature.
The flexibility of restraining wire 60 allows portion 62 of restraining wire 60 to extend outward from inner shaft 36, when restraining wire 60 is disposed in first and second enclosed longitudinal segments 52 and 54. As a result, restraining wire 60 engages longitudinal portion 70 of stent-graft 40 at one or more locations outside of inner shaft 36. This outward extension of the restraining wire allows restraining wire 60 to physically engage longitudinal portion 70 of stent-graft 40, without any elements of the stent-graft projecting into the interior of the inner shaft. As a result, the inner shaft may be provided with a relatively small diameter, such as no more than 4 mm, which enables the delivery shaft to have a small crossing profile when loaded with the stent-graft. Typically, deployment system 10, including delivery shaft 30 thereof, is configured such that a greatest distance of restraining wire 60 from the external surface of inner shaft 36 is no more than 1 mm, when portion 62 of restraining wire 60 engages longitudinal portion 70 of stent-graft 40, and the stent-graft is not otherwise constrained (such as by outer sheath 34 or the wall of the blood vessel).
Reference is still made to
Typically, restraining wire 60 comprises a metal. Typically, in order for the restraining wire to function more like a restraining beam than a suturing filament, as described hereinabove, the restraining wire has a stiffness (moment of inertia) of at least 0.0002 Mm4, and/or a Young's modulus of at least 60 GPa, such as at least 80 GPa. For some applications, restraining wire comprises a metal alloy, e.g., Nitinol, e.g., having a diameter of between 0.08 and 0.3 mm, such as 0.1 mm or 0.3 mm. For some applications, the Nitinol is “solid” tube. For applications in which the wire comprises Nitinol, the wire typically has a PTFE coating, so as to reduce friction with the wall of the conduit during withdrawal of the wire to release the stent-graft. For other applications, restraining wire 60 comprises stainless steel, such as flexible stainless steel, e.g., 440C stainless steel, e.g., having a diameter of between 0.08 and 0.3 mm, such as 0.1 mm. For some applications, the at least one restraining wire 60 is solid, while for other applications, the at least one restraining wire 60 is shaped so as to define one or more internal bores; for the example, the wire may comprise a plurality of strands, or may be shaped as a hollow tube.
For some applications, such as shown in
Reference is made to
Reference is made to
For some applications, first and second rings 90 and 92 comprise a radiopaque metal, such as tantalum. The radiopaque material enables the surgeon to visualize the ends of restraining longitudinal portion 56 during an implantation procedure, which may aid in the proper positioning of inner shaft 36 and stent-graft 40 during the procedure.
Reference is made to
For example:
Typically, respective proximal portions 72 of restraining wires 60 are coupled to withdrawal actuator 700 of control handle 20, such as described hereinbelow with reference to
Typically, restraining wires 60 are stiff enough to prevent full radial expansion of longitudinal portion 70 of stent-graft 40 when removably disposed in first enclosed longitudinal segments 52 and second enclosed longitudinal segments 54, even when there is no tensile stress in the restraining wires, i.e., when the wires are loose because no tensile force is applied to respective proximal portions 72 of the restraining wires, such as described hereinbelow with reference to
Reference is made to
In this configuration, deployment system 10 is configured such that:
For some applications, a longitudinal distance between longitudinally-closest ends of first and second longitudinal portions 70 and 170 of stent-graft 40 equals at least 10% of an average of (a) a perimeter of first longitudinal portion 70 of stent-graft 40 and (b) a perimeter of second longitudinal portion 170 of stent-graft 40, such as least 20% of the average, when the stent-graft is unconstrained in a fully radially-expanded state, i.e., no forces are applied to the stent-graft by deployment system 10 (such as outer sheath 34), walls of a blood vessel, or otherwise (including that no forces are applied to longitudinally-adjacent portions of the stent-graft, which forces would reduce the perimeters of first and second longitudinal portions 70 and 170). Alternatively or additionally, for some applications, the longitudinal distance is at least 10 mm, such as at least 20 mm, e.g., at least 30 mm.
Typically, restraining wire 60 is stiff enough to prevent full radial expansion of first and second longitudinal portions 70 and 170 of stent-graft 40 when removably disposed in first, second, and third enclosed longitudinal segments 52, 54, and 58 even when there is no tensile stress in the restraining wire, i.e., when the wire is loose because no tensile force is applied to proximal portion 72 of the restraining wire, such as described hereinbelow with reference to
Reference is made to
Typically, each of conduits 50 is disposed at a constant angular location (or “o'clock”) along inner shaft 36. Alternatively, respective portions of each of conduits 50 are disposed at different angular locations at different longitudinal locations along the inner shaft. For example, the angular location of a conduit may shift on opposite longitudinal sides of a restraining longitudinal portion.
For some applications in which a plurality of restraining wires 60 is provided, the restraining wires are removably positioned within differing numbers of conduits 50 at different longitudinal locations along inner shaft 36. For example, two restraining wires 60 may be positioned in two respective conduits 50 along second enclosed longitudinal segments 54, and in the same single conduit 50 along first enclosed longitudinal segment 52. In other words, the two restraining wires merge into a single conduit along first enclosed longitudinal segment 52. Similarly, four restraining wires 60 may be positioned in four respective conduits 50 along second enclosed longitudinal segments 54, and two of the wires may be positioned in a first single conduit along first enclosed longitudinal segment 52 and two of the wires may be positioned in a different single conduit along first enclosed longitudinal segment 52.
Reference is now made to
Although conduits 50 are shown in
Reference is now made to
Although conduits 50 are shown in
Reference is now made to
For some applications, third longitudinal portion 270 is longitudinally disposed between first and second longitudinal portions 70 and 170, as shown in
Although conduits 50 are shown in
Reference is now made to
As shown in
As shown in
As shown in
Thereafter, as shown in
Although conduits 50 are shown in
Reference is now made to
Deployment system 410 is configured to enable controlled separate deployment of two or more longitudinal portions of stent-graft 40, not necessarily in the order in which the longitudinal portions are disposed along the stent-graft. Deployment system 410 comprises:
For example, the at least one first restraining wire 460 may comprise first restraining wires 460A and 460B (as shown in
During a deployment procedure, either the at least one first restraining wire 460 or the at least one second restraining wire 462 is first proximally withdrawn, depending on whether it is desired to first allow full radial expansion of first longitudinal portion 470, or of second longitudinal portion 570. After (e.g., at least one second after) the at least one first restraining wire 460 or the at least one restraining wire 462 is at least partially withdrawn, the other of the at least one restraining wires is withdrawn. For some applications, a first subset of the restraining wires, which includes the at least one first restraining wire 460, is withdrawn, and, thereafter, a second subset of the restraining wires, which includes the at least one second restraining wire 462, is withdrawn. Alternatively, for some applications, a second subset of the restraining wires, which includes the at least one second restraining wire 462, is withdrawn, and, thereafter, a first subset of the restraining wires, which includes the at least one first restraining wire 460, is withdrawn. In either case, the second subset is different from the first subset.
For some applications, as shown in
Typically, an inner shaft 436 of delivery shaft 430 is shaped so as to define at least one first conduit 450 therealong. For example, the at least one first conduit 450 may comprise first conduits 450A and 450B (as shown in
Typically, inner shaft 436 of delivery shaft 430 is also shaped so as to define at least one second conduit 480 therealong. For example, the at least one second conduit 480 may comprise second conduits 480A and 480B (as shown in
First and second restraining longitudinal portions 456 and 486 typically do not longitudinally overlap each other. For some applications, a longitudinal distance between longitudinally-closest ends of first and second restraining longitudinal portions 456 and 486 is at least 10 mm, such as at least 30 mm. Typically, first restraining longitudinal portion 456 at least partially longitudinally overlaps one of third and fourth enclosed longitudinal segments 482 and 484 (by way of example, in
Inner shaft 436 may have the outer diameters set forth hereinabove for inner shaft 36, and first and second enclosed longitudinal segments 452 and 454 and/or third and fourth enclosed longitudinal segments 482 and 484 may have the inner diameters set forth hereinabove for enclosed longitudinal segments 52 and 54.
The at least one first conduits 450 and the at least one second conduit 480 are typically not coaxial with inner shaft 36, and are not coaxial with one another. For applications in which restraining longitudinal portion 456 is open, and thus cannot define any centroids in cross-section, the central longitudinal axis of restraining longitudinal portion 456 is defined by extending the central longitudinal axis of adjacent enclosed first and second longitudinal segments 452 and 454 along restraining longitudinal portion 456. Similarly, for applications in which restraining longitudinal portion 486 is open, and thus cannot define any centroids in cross-section, the central longitudinal axis of restraining longitudinal portion 486 is defined by extending the central longitudinal axis of adjacent enclosed third and fourth enclosed longitudinal segments 482 and 484 along restraining longitudinal portion 486.
Typically, deployment system 410 is configured such that:
Typically, a proximal portion 472A of the at least one first restraining wire 460 is coupled to a first withdrawal actuator 800 of control handle 20, such as described hereinbelow with reference to
For some applications, a longitudinal distance between longitudinally-closest ends of first and second longitudinal portions 470 and 570 of stent-graft 40 equals at least 10% of an average of (a) a perimeter of first longitudinal portion 470 of stent-graft 40 and (b) a perimeter of second longitudinal portion 570 of stent-graft 40, such as least 20% of the average, when the stent-graft is unconstrained in a fully radially-expanded state, i.e., no forces are applied to the stent-graft by deployment system 410 (such as outer sheath 34), walls of a blood vessel, or otherwise (including that no forces are applied to longitudinally-adjacent portions of the stent-graft, which forces would reduce the perimeters of first and second longitudinal portions 470 and 570). Alternatively or additionally, for some applications, the longitudinal distance is at least 10 mm, such as at least 20 mm, e.g., at least 30 mm.
For some applications, the at least one second restraining wire 462, when removably disposed in physical engagement with third longitudinal portion 670 of stent-graft 40, prevents full radial expansion of third longitudinal portion, and the at least one first restraining wire 460 does not engage third longitudinal portion 670 of stent-graft 40. Third longitudinal portion 670 does not longitudinally overlap first or second longitudinal portions 470 and 570, and first longitudinal portion 470 is longitudinally disposed between second and third longitudinal portions 570 and 670.
Reference is now made to
As shown in
As shown in
As shown in
As shown in
As shown in
As mentioned above, first longitudinal portion of 470 of stent-graft 140 is still constrained when the guidewires and cannulae are advanced through the lateral fenestrations and into the branching arteries. This allows the operator to adjust the longitudinal and/or rotational disposition of the stent-graft as necessary to best align the fenestrations with the ostia of the branching arteries, because the non-expanded first longitudinal portion of 470 is not constrained by the wall of the aorta.
As shown in
At this stage of the deployment, the at least one second restraining wire 262 is still removably disposed in third and fourth enclosed longitudinal segments 482 and 484, and thus continues to prevent the full radial expansion of second longitudinal portion 570. This permits adjustment of the longitudinal and/or rotational disposition of the distal portion of the stent-graft if necessary.
Cannulae 682A, 682B, and 682C are withdrawn from the body over their respective guidewires. As shown in
As shown in
Although second conduits 480 are shown in
Reference is now made to
For some applications, as can be seen in
For some applications, withdrawal actuator 700 comprises a mechanism other than a spool, such as a slider.
For some applications, spool 720 is configured to be rotatable only in one direction, in order to allow only proximal withdrawal of restraining wire(s) 60, and to prevent accidental distal promotion of the restraining wire(s). Because the restraining wire(s) may have a small diameter, accidental distal advancement of the wire(s) might puncture covering element 44 of the stent-graft and/or the vascular wall. For some applications, spool 720 comprises a ratchet assembly 730, which, for some applications, comprises a saw-toothed gear 732 and a pawl 736. Gear 732 is mounted on the same axis as spool 720. Gear 732 and pawl 736 are arranged such that the pawl interlocks with teeth 734 of saw-toothed gear 732, allowing rotation of the gear, and thus spool 720, in only one direction.
For some applications, the spools described hereinbelow with reference to
As described hereinabove with reference to
Reference is made to
For some applications, first and second withdrawal actuators 800 and 802 comprise first and second spools 820 and 840, respectively, to which proximal portion(s) 472A of first restraining wire(s) 460 and proximal portions 472B or second restraining wires(s) 462, respectively, are coupled. Spools 820 and 840 are arranged such that rotation thereof withdraws first and second restraining wire(s) 460 and 462, respectively, and in the proximal direction. For these applications, first and second withdrawal actuators 800 and 702 typically further comprise first and second knobs 822 and 842, respectively, which are fixed to first and second spools 820 and 840, respectively, such that rotation of the knobs rotates the spools, respectively. First and second withdrawal actuators 800 and 802 thus provides a convenient way for the operator to withdraw first restraining wire(s) 460 separately (e.g., before) from second restraining wire(s) 462, without needing to draw them a distance from the subject's body. Thus, first withdrawal actuator 800 is used to withdraw one subset of the restraining wires, and second withdrawal actuator 802 is used to withdrawn another subset of the restraining wires.
For some applications, first and second withdrawal actuators 800 and 802 comprise respective mechanisms other than spools, such as sliders.
As described hereinabove with reference to
Reference is made to
Optionally, the control handle comprises another actuating mechanism for withdrawing the at least one second restraining wire 462, such as a slider (configuration not shown).
The use of only a single withdrawal actuator 800 may potentially prevent (a) confusion that might arise between the two actuators 800 and 802 in the configuration described with reference to
As described hereinabove with reference to
Although the techniques described herein have been generally described for implanting a stent-graft in a blood vessel, the techniques maybe used to implant other implantable medical devices that are introduced into the body in a relatively compact state and used within the body in a relatively expanded state. Non-limiting examples of such implantable medical devices include stents, coil stents and filters, catheters, cannulae, intrauterine contraceptive devices (IUDs), bone plates, marrow nails, dental arch wires, filters, bone staples, heart valves, and clips.
The scope of the present invention includes embodiments described in the following applications, which are assigned to the assignee of the present application and are incorporated herein by reference. In an embodiment, techniques and apparatus described in one or more of the following patent applications are combined with techniques and apparatus described herein. In particular, the techniques described herein may be used to deliver any of the radially-compressible stent-grafts and stents described in the following patent applications.
It will be appreciated by persons skilled in the art that the present invention is not limited to what has been particularly shown and described hereinabove. Rather, the scope of the present invention includes both combinations and subcombinations of the various features described hereinabove, as well as variations and modifications thereof that are not in the prior art, which would occur to persons skilled in the art upon reading the foregoing description.
The present application is the U.S. national stage of International Application PCT/IL2014/050973, filed Nov. 6, 2014, which claims priority from (a) U.S. Provisional Application 61/906,014, filed Nov. 19, 2013, and (b) U.S. Provisional Application 61/926,533, filed Jan. 13, 2014, both of which applications are assigned to the assignee of the present application and are incorporated herein by reference.
| Filing Document | Filing Date | Country | Kind |
|---|---|---|---|
| PCT/IL2014/050973 | 11/6/2014 | WO | 00 |
| Publishing Document | Publishing Date | Country | Kind |
|---|---|---|---|
| WO2015/075708 | 5/28/2015 | WO | A |
| Number | Name | Date | Kind |
|---|---|---|---|
| 4180613 | Vassiliou | Dec 1979 | A |
| 4355426 | MacGregor | Oct 1982 | A |
| 4505767 | Quin | Mar 1985 | A |
| 4562596 | Kornberg | Jan 1986 | A |
| 4577631 | Kreamer | Mar 1986 | A |
| 4617932 | Kornberg | Oct 1986 | A |
| 4665906 | Jervis | May 1987 | A |
| 4739762 | Palmaz | Apr 1988 | A |
| 4787899 | Lazarus | Nov 1988 | A |
| 4816339 | Tu et al. | Mar 1989 | A |
| 4878906 | Lindemann et al. | Nov 1989 | A |
| 4886062 | Wiktor | Dec 1989 | A |
| 4938740 | Melbin | Jul 1990 | A |
| 4969458 | Wiktor | Nov 1990 | A |
| 5042707 | Taheri | Aug 1991 | A |
| 5064435 | Porter | Nov 1991 | A |
| 5104404 | Wolff | Apr 1992 | A |
| 5122136 | Guglielmi et al. | Jun 1992 | A |
| 5129910 | Phan et al. | Jul 1992 | A |
| 5133732 | Wiktor | Jul 1992 | A |
| 5192256 | Ryan | Mar 1993 | A |
| 5192286 | Phan et al. | Mar 1993 | A |
| 5234448 | Wholey et al. | Aug 1993 | A |
| 5383926 | Lock et al. | Jan 1995 | A |
| 5425739 | Jessen | Jun 1995 | A |
| 5425765 | Tiefenbrun et al. | Jun 1995 | A |
| 5439446 | Barry | Aug 1995 | A |
| 5456694 | Marin et al. | Oct 1995 | A |
| 5486183 | Middleman et al. | Jan 1996 | A |
| 5507769 | Marin et al. | Apr 1996 | A |
| 5509923 | Middleman et al. | Apr 1996 | A |
| 5522880 | Barone et al. | Jun 1996 | A |
| 5527322 | Klein et al. | Jun 1996 | A |
| 5549662 | Fordenbacher | Aug 1996 | A |
| 5554181 | Das | Sep 1996 | A |
| 5556413 | Lam | Sep 1996 | A |
| 5562724 | Vorwerk et al. | Oct 1996 | A |
| 5575818 | Pinchuk | Nov 1996 | A |
| 5607445 | Summers | Mar 1997 | A |
| 5613974 | Andreas et al. | Mar 1997 | A |
| 5632746 | Middleman et al. | May 1997 | A |
| 5632763 | Glastra | May 1997 | A |
| 5632772 | Alcime et al. | May 1997 | A |
| 5639278 | Dereume et al. | Jun 1997 | A |
| 5643340 | Nunokawa | Jul 1997 | A |
| 5653743 | Martin | Aug 1997 | A |
| 5676696 | Marcade | Oct 1997 | A |
| 5676697 | McDonald | Oct 1997 | A |
| 5693084 | Chuter | Dec 1997 | A |
| 5728134 | Barak | Mar 1998 | A |
| 5749825 | Fischell et al. | May 1998 | A |
| 5749879 | Middleman et al. | May 1998 | A |
| 5755770 | Ravenscroft | May 1998 | A |
| 5755771 | Penn et al. | May 1998 | A |
| 5755774 | Pinchuk | May 1998 | A |
| 5755777 | Chuter | May 1998 | A |
| 5755781 | Jayaraman | May 1998 | A |
| 5769882 | Fogarty et al. | Jun 1998 | A |
| 5769884 | Solovay | Jun 1998 | A |
| 5782903 | Wiktor | Jul 1998 | A |
| 5782906 | Marshall et al. | Jul 1998 | A |
| 5792172 | Fischell et al. | Aug 1998 | A |
| 5824040 | Cox et al. | Oct 1998 | A |
| 5824055 | Spiridigliozzi et al. | Oct 1998 | A |
| 5827321 | Roubin | Oct 1998 | A |
| 5843170 | Ahn | Dec 1998 | A |
| 5855600 | Alt | Jan 1999 | A |
| 5860991 | Klein et al. | Jan 1999 | A |
| 5876432 | Lau et al. | Mar 1999 | A |
| 5906641 | Thompson et al. | May 1999 | A |
| 5921994 | Andreas et al. | Jul 1999 | A |
| 5925076 | Inoue | Jul 1999 | A |
| 5944750 | Tanner et al. | Aug 1999 | A |
| 5948018 | Dereume et al. | Sep 1999 | A |
| 5968091 | Pinchuk et al. | Oct 1999 | A |
| 5976178 | Goldsteen et al. | Nov 1999 | A |
| 5980552 | Pinchasik | Nov 1999 | A |
| 5984955 | Wisselink | Nov 1999 | A |
| 6015431 | Thornton et al. | Jan 2000 | A |
| 6016810 | Ravenscroft | Jan 2000 | A |
| 6030414 | Taheri | Feb 2000 | A |
| 6033435 | Penn et al. | Mar 2000 | A |
| 6036723 | Anidjar et al. | Mar 2000 | A |
| 6036725 | Avellanet | Mar 2000 | A |
| 6049824 | Simonin | Apr 2000 | A |
| 6051021 | Frid | Apr 2000 | A |
| 6059824 | Taheri | May 2000 | A |
| 6077298 | Tu et al. | Jun 2000 | A |
| 6099497 | Adams et al. | Aug 2000 | A |
| 6099548 | Taheri | Aug 2000 | A |
| 6117145 | Wood et al. | Sep 2000 | A |
| 6129738 | Lashinski et al. | Oct 2000 | A |
| 6132457 | Chobotov | Oct 2000 | A |
| 6152956 | Pierce | Nov 2000 | A |
| 6156064 | Chouinard | Dec 2000 | A |
| 6159228 | Frid et al. | Dec 2000 | A |
| 6168615 | Ken et al. | Jan 2001 | B1 |
| 6176875 | Lenker et al. | Jan 2001 | B1 |
| 6179878 | Duerig et al. | Jan 2001 | B1 |
| 6200339 | Leschinsky et al. | Mar 2001 | B1 |
| 6206893 | Klein et al. | Mar 2001 | B1 |
| 6270524 | Kim | Aug 2001 | B1 |
| 6283991 | Cox et al. | Sep 2001 | B1 |
| 6287335 | Drasler et al. | Sep 2001 | B1 |
| 6290720 | Khosravi et al. | Sep 2001 | B1 |
| 6296661 | Davila et al. | Oct 2001 | B1 |
| 6312458 | Golds | Nov 2001 | B1 |
| 6319287 | Frimberger | Nov 2001 | B1 |
| 6325819 | Pavcnik et al. | Dec 2001 | B1 |
| 6325823 | Horzewski et al. | Dec 2001 | B1 |
| 6344056 | Dehdashtian | Feb 2002 | B1 |
| 6395018 | Castaneda | May 2002 | B1 |
| 6406420 | McCarthy | Jun 2002 | B1 |
| 6428565 | Wisselink | Aug 2002 | B1 |
| 6451048 | Berg et al. | Sep 2002 | B1 |
| 6451051 | Drasler et al. | Sep 2002 | B2 |
| 6471722 | Inoue | Oct 2002 | B1 |
| 6506211 | Skubitz et al. | Jan 2003 | B1 |
| 6520988 | Colombo et al. | Feb 2003 | B1 |
| 6544279 | Hopkins et al. | Apr 2003 | B1 |
| 6565597 | Fearnot et al. | May 2003 | B1 |
| 6576009 | Ryan et al. | Jun 2003 | B2 |
| 6613075 | Healy et al. | Sep 2003 | B1 |
| 6613078 | Barone | Sep 2003 | B1 |
| 6635083 | Cheng et al. | Oct 2003 | B1 |
| 6645242 | Quinn | Nov 2003 | B1 |
| 6648901 | Fleischman et al. | Nov 2003 | B2 |
| 6648911 | Sirhan | Nov 2003 | B1 |
| 6652567 | Deaton | Nov 2003 | B1 |
| 6652571 | White et al. | Nov 2003 | B1 |
| 6656214 | Fogarty et al. | Dec 2003 | B1 |
| 6673080 | Reynolds et al. | Jan 2004 | B2 |
| 6692520 | Gambale et al. | Feb 2004 | B1 |
| 6695833 | Frantzen | Feb 2004 | B1 |
| 6695875 | Stelter et al. | Feb 2004 | B2 |
| 6699277 | Freidberg et al. | Mar 2004 | B1 |
| 6716238 | Elliot | Apr 2004 | B2 |
| 6729356 | Baker et al. | May 2004 | B1 |
| 6730117 | Tseng et al. | May 2004 | B1 |
| 6733523 | Shaolian et al. | May 2004 | B2 |
| 6743195 | Zucker | Jun 2004 | B2 |
| 6748953 | Sherry et al. | Jun 2004 | B2 |
| 6752826 | Wholey et al. | Jun 2004 | B2 |
| 6776794 | Hong et al. | Aug 2004 | B1 |
| 6808534 | Escano | Oct 2004 | B1 |
| 6814749 | Cox et al. | Nov 2004 | B2 |
| 6814752 | Chuter | Nov 2004 | B1 |
| 6824560 | Pelton | Nov 2004 | B2 |
| 6843803 | Ryan et al. | Jan 2005 | B2 |
| 6846321 | Zucker | Jan 2005 | B2 |
| 6860900 | Clerc et al. | Mar 2005 | B2 |
| 6907285 | Denker et al. | Jun 2005 | B2 |
| 6908477 | McGuckin, Jr. et al. | Jun 2005 | B2 |
| 6929660 | Ainsworth et al. | Aug 2005 | B1 |
| 6942691 | Chuter | Sep 2005 | B1 |
| 6953469 | Ryan | Oct 2005 | B2 |
| 6964679 | Marcade et al. | Nov 2005 | B1 |
| 6986774 | Middleman et al. | Jan 2006 | B2 |
| 7008441 | Zucker | Mar 2006 | B2 |
| 7018400 | Lashinski et al. | Mar 2006 | B2 |
| 7022131 | DeRowe et al. | Apr 2006 | B1 |
| 7044962 | Elliott | May 2006 | B2 |
| 7083822 | Brightbill | Aug 2006 | B2 |
| 7105015 | Goshgarian | Sep 2006 | B2 |
| 7105020 | Greenberg et al. | Sep 2006 | B2 |
| 7112217 | Kugler et al. | Sep 2006 | B1 |
| 7115127 | Lindenbaum et al. | Oct 2006 | B2 |
| 7122052 | Greenhalgh | Oct 2006 | B2 |
| 7131991 | Zarins et al. | Nov 2006 | B2 |
| 7144421 | Carpenter et al. | Dec 2006 | B2 |
| 7160318 | Greenberg et al. | Jan 2007 | B2 |
| 7175651 | Kerr | Feb 2007 | B2 |
| 7198638 | Dong | Apr 2007 | B2 |
| 7201772 | Schwammenthal et al. | Apr 2007 | B2 |
| 7220274 | Quinn | May 2007 | B1 |
| 7223266 | Lindenbaum et al. | May 2007 | B2 |
| 7261733 | Brown et al. | Aug 2007 | B1 |
| 7270675 | Chun et al. | Sep 2007 | B2 |
| 7279003 | Berra et al. | Oct 2007 | B2 |
| 7294145 | Ward | Nov 2007 | B2 |
| 7294147 | Hartley | Nov 2007 | B2 |
| 7306623 | Watson | Dec 2007 | B2 |
| 7341598 | Davidson et al. | Mar 2008 | B2 |
| 7393357 | Stelter et al. | Jul 2008 | B2 |
| 7396363 | Frid | Jul 2008 | B2 |
| 7399313 | Brown et al. | Jul 2008 | B2 |
| 7407509 | Greenberg et al. | Aug 2008 | B2 |
| 7413573 | Hartley et al. | Aug 2008 | B2 |
| 7425219 | Quadri | Sep 2008 | B2 |
| 7429269 | Schwammenthal et al. | Sep 2008 | B2 |
| 7438721 | Doig et al. | Oct 2008 | B2 |
| 7442204 | Schwammenthal et al. | Oct 2008 | B2 |
| 7473272 | Pryor | Jan 2009 | B2 |
| 7491231 | Nazzaro et al. | Feb 2009 | B2 |
| 7537606 | Hartley et al. | May 2009 | B2 |
| 7537609 | Davidson et al. | May 2009 | B2 |
| 7540881 | Meyer et al. | Jun 2009 | B2 |
| 7544160 | Gross | Jun 2009 | B2 |
| 7575590 | Watson | Aug 2009 | B2 |
| 7616997 | Kieval et al. | Nov 2009 | B2 |
| 7637939 | Tischler | Dec 2009 | B2 |
| 7645298 | Hartley et al. | Jan 2010 | B2 |
| 7655036 | Goodson | Feb 2010 | B2 |
| 7662161 | Briganti et al. | Feb 2010 | B2 |
| 7662168 | McGuckin, Jr. et al. | Feb 2010 | B2 |
| 7670369 | Schaeffer | Mar 2010 | B2 |
| 7678141 | Greenan et al. | Mar 2010 | B2 |
| 7699885 | Leonhardt et al. | Apr 2010 | B2 |
| 7708704 | Mitelberg | May 2010 | B2 |
| 7722626 | Middleman et al. | May 2010 | B2 |
| 7731732 | Ken | Jun 2010 | B2 |
| 7766955 | Vardi et al. | Aug 2010 | B2 |
| 7771465 | Zukowski | Aug 2010 | B2 |
| 7789903 | Spiridigliozzi et al. | Sep 2010 | B2 |
| 7803177 | Hartley et al. | Sep 2010 | B2 |
| 7803178 | Whirley | Sep 2010 | B2 |
| 7806923 | Moloney | Oct 2010 | B2 |
| 7815673 | Bloom et al. | Oct 2010 | B2 |
| 7833259 | Boatman | Nov 2010 | B2 |
| 7846194 | Hartley et al. | Dec 2010 | B2 |
| 7850725 | Vardi et al. | Dec 2010 | B2 |
| 7867270 | Hartley et al. | Jan 2011 | B2 |
| 7887575 | Kujawski | Feb 2011 | B2 |
| 7914572 | Hartley et al. | Mar 2011 | B2 |
| 7955373 | Sowinski et al. | Jun 2011 | B2 |
| 7955374 | Erickson et al. | Jun 2011 | B2 |
| 7959662 | Erbel et al. | Jun 2011 | B2 |
| 7959669 | Chalekian et al. | Jun 2011 | B2 |
| 7998186 | Hartley | Aug 2011 | B2 |
| 7998187 | Hartley et al. | Aug 2011 | B2 |
| 8012193 | Hartley et al. | Sep 2011 | B2 |
| 8016853 | Griffen et al. | Sep 2011 | B2 |
| 8021412 | Hartley et al. | Sep 2011 | B2 |
| 8021418 | Gerberding et al. | Sep 2011 | B2 |
| 8021419 | Hartley et al. | Sep 2011 | B2 |
| 8043365 | Thramann | Oct 2011 | B2 |
| 8048139 | Frid et al. | Nov 2011 | B2 |
| 8048140 | Purdy | Nov 2011 | B2 |
| 8048147 | Adams | Nov 2011 | B2 |
| 8052736 | Doig et al. | Nov 2011 | B2 |
| 8052741 | Bruszewski et al. | Nov 2011 | B2 |
| 8066755 | Zacharias | Nov 2011 | B2 |
| 8080026 | Konstantino et al. | Dec 2011 | B2 |
| 8080053 | Satasiya | Dec 2011 | B2 |
| 8100960 | Bruszewski | Jan 2012 | B2 |
| 8118854 | Bowe | Feb 2012 | B2 |
| 8133267 | Leonhardt et al. | Mar 2012 | B2 |
| 8157810 | Case et al. | Apr 2012 | B2 |
| 8157852 | Bloom et al. | Apr 2012 | B2 |
| 8167926 | Hartley et al. | May 2012 | B2 |
| 8172892 | Chuter | May 2012 | B2 |
| 8172895 | Anderson et al. | May 2012 | B2 |
| 8197475 | Bruszewski et al. | Jun 2012 | B2 |
| 8197533 | Kujawski | Jun 2012 | B2 |
| 8211158 | Wolf | Jul 2012 | B2 |
| 8216298 | Wright et al. | Jul 2012 | B2 |
| 8221494 | Schreck et al. | Jul 2012 | B2 |
| 8226706 | Hartley et al. | Jul 2012 | B2 |
| 8236040 | Mayberry et al. | Aug 2012 | B2 |
| 8251963 | Chin et al. | Aug 2012 | B2 |
| 8257423 | Kerr | Sep 2012 | B2 |
| 8262719 | Erickson et al. | Sep 2012 | B2 |
| 8273115 | Hamer et al. | Sep 2012 | B2 |
| 8287586 | Schaeffer et al. | Oct 2012 | B2 |
| 8292885 | Bruszewski et al. | Oct 2012 | B2 |
| 8292941 | Muzslay | Oct 2012 | B2 |
| 8292949 | Berra et al. | Oct 2012 | B2 |
| 8292951 | Muzslay | Oct 2012 | B2 |
| 8333800 | Bruszewski et al. | Dec 2012 | B2 |
| 8337546 | Bruszewski | Dec 2012 | B2 |
| 8353898 | Lutze et al. | Jan 2013 | B2 |
| 8357192 | Mayberry et al. | Jan 2013 | B2 |
| 8361134 | Hartley et al. | Jan 2013 | B2 |
| 8394136 | Hartley et al. | Mar 2013 | B2 |
| 8425585 | Melsheimer et al. | Apr 2013 | B2 |
| 8470018 | Hartley et al. | Jun 2013 | B2 |
| 8475513 | Sithian | Jul 2013 | B2 |
| 8480726 | Cunningham et al. | Jul 2013 | B2 |
| 8486131 | Shalev | Jul 2013 | B2 |
| 8491646 | Schreck | Jul 2013 | B2 |
| 8506622 | Bruszewski et al. | Aug 2013 | B2 |
| 8728148 | Roeder et al. | May 2014 | B2 |
| 8808355 | Barrand | Aug 2014 | B2 |
| 8945203 | Shalev et al. | Feb 2015 | B2 |
| 8968384 | Pearson et al. | Mar 2015 | B2 |
| 9101457 | Benary | Aug 2015 | B2 |
| 9168123 | Barrand | Oct 2015 | B2 |
| 9254209 | Shalev | Feb 2016 | B2 |
| 9278018 | Roeder | Mar 2016 | B2 |
| 9526638 | Shalev et al. | Dec 2016 | B2 |
| 9597204 | Benary et al. | Mar 2017 | B2 |
| 20010000188 | Lenker et al. | Apr 2001 | A1 |
| 20010003161 | Vardi et al. | Jun 2001 | A1 |
| 20010004705 | Killion | Jun 2001 | A1 |
| 20010010006 | Bachinski et al. | Jul 2001 | A1 |
| 20010014823 | Resseman et al. | Aug 2001 | A1 |
| 20010034550 | Buirge | Oct 2001 | A1 |
| 20010037142 | Stelter et al. | Nov 2001 | A1 |
| 20010044647 | Pinchuk et al. | Nov 2001 | A1 |
| 20010044651 | Steinke | Nov 2001 | A1 |
| 20010044652 | Moore | Nov 2001 | A1 |
| 20010047198 | Drasler | Nov 2001 | A1 |
| 20010049550 | Martin et al. | Dec 2001 | A1 |
| 20010053930 | Kugler et al. | Dec 2001 | A1 |
| 20020040236 | Lau | Apr 2002 | A1 |
| 20020052643 | Wholey et al. | May 2002 | A1 |
| 20020052644 | Shaolian et al. | May 2002 | A1 |
| 20020072790 | McGuckin et al. | Jun 2002 | A1 |
| 20020099438 | Furst | Jul 2002 | A1 |
| 20020099441 | Dehdashtian | Jul 2002 | A1 |
| 20020107564 | Cox | Aug 2002 | A1 |
| 20020111667 | Girton et al. | Aug 2002 | A1 |
| 20020123791 | Harrison | Sep 2002 | A1 |
| 20020156495 | Brenneman et al. | Oct 2002 | A1 |
| 20020156517 | Prouse et al. | Oct 2002 | A1 |
| 20020173809 | Fleischman et al. | Nov 2002 | A1 |
| 20020183783 | Shadduck | Dec 2002 | A1 |
| 20020193864 | Khosravi et al. | Dec 2002 | A1 |
| 20020198585 | Wisselink | Dec 2002 | A1 |
| 20030033005 | Houser et al. | Feb 2003 | A1 |
| 20030040791 | Oktay | Feb 2003 | A1 |
| 20030040804 | Stack et al. | Feb 2003 | A1 |
| 20030057156 | Peterson et al. | Mar 2003 | A1 |
| 20030065345 | Weadock | Apr 2003 | A1 |
| 20030065386 | Weadock | Apr 2003 | A1 |
| 20030074055 | Haverkost | Apr 2003 | A1 |
| 20030093145 | Lawrence-Brown et al. | May 2003 | A1 |
| 20030114061 | Matsuda et al. | Jun 2003 | A1 |
| 20030125796 | Dong | Jul 2003 | A1 |
| 20030130720 | DePalma et al. | Jul 2003 | A1 |
| 20030139802 | Wulfman et al. | Jul 2003 | A1 |
| 20030139805 | Holmberg et al. | Jul 2003 | A1 |
| 20030144725 | Lombardi | Jul 2003 | A1 |
| 20030153944 | Phung et al. | Aug 2003 | A1 |
| 20030153968 | Geis et al. | Aug 2003 | A1 |
| 20030163187 | Weber | Aug 2003 | A1 |
| 20030171771 | Anderson et al. | Sep 2003 | A1 |
| 20030191523 | Hojeibane | Oct 2003 | A1 |
| 20030199967 | Hartley et al. | Oct 2003 | A1 |
| 20030199968 | Ainsworth et al. | Oct 2003 | A1 |
| 20030204236 | Letort | Oct 2003 | A1 |
| 20030204242 | Zarins et al. | Oct 2003 | A1 |
| 20030204243 | Shiu | Oct 2003 | A1 |
| 20030208192 | Truckai et al. | Nov 2003 | A1 |
| 20030212449 | Cox | Nov 2003 | A1 |
| 20030233117 | Adams et al. | Dec 2003 | A1 |
| 20030236567 | Elliot | Dec 2003 | A1 |
| 20040015227 | Vardi et al. | Jan 2004 | A1 |
| 20040015229 | Fulkerson | Jan 2004 | A1 |
| 20040073289 | Hartley | Apr 2004 | A1 |
| 20040098091 | Erbel | May 2004 | A1 |
| 20040106972 | Deaton | Jun 2004 | A1 |
| 20040106978 | Greenberg et al. | Jun 2004 | A1 |
| 20040117003 | Ouriel et al. | Jun 2004 | A1 |
| 20040133266 | Clerc et al. | Jul 2004 | A1 |
| 20040138735 | Shaolian et al. | Jul 2004 | A1 |
| 20040162606 | Thompson | Aug 2004 | A1 |
| 20040171978 | Shalaby | Sep 2004 | A1 |
| 20040176832 | Hartley et al. | Sep 2004 | A1 |
| 20040181149 | Langlotz et al. | Sep 2004 | A1 |
| 20040215319 | Berra et al. | Oct 2004 | A1 |
| 20040215320 | Machek | Oct 2004 | A1 |
| 20040215327 | Doig et al. | Oct 2004 | A1 |
| 20040215332 | Frid | Oct 2004 | A1 |
| 20040260383 | Stelter et al. | Dec 2004 | A1 |
| 20050010246 | Streeter et al. | Jan 2005 | A1 |
| 20050033406 | Barnhart et al. | Feb 2005 | A1 |
| 20050049678 | Cocks et al. | Mar 2005 | A1 |
| 20050059923 | Gamboa | Mar 2005 | A1 |
| 20050065545 | Wallace | Mar 2005 | A1 |
| 20050070995 | Zilla et al. | Mar 2005 | A1 |
| 20050085900 | Case | Apr 2005 | A1 |
| 20050102018 | Carpenter et al. | May 2005 | A1 |
| 20050102021 | Osborne | May 2005 | A1 |
| 20050131512 | Vonderwalde | Jun 2005 | A1 |
| 20050131517 | Hartley et al. | Jun 2005 | A1 |
| 20050137682 | Justino | Jun 2005 | A1 |
| 20050143802 | Soykan et al. | Jun 2005 | A1 |
| 20050149166 | Schaeffer et al. | Jul 2005 | A1 |
| 20050154448 | Cully | Jul 2005 | A1 |
| 20050159803 | Lad et al. | Jul 2005 | A1 |
| 20050165480 | Jordan et al. | Jul 2005 | A1 |
| 20050171598 | Schaeffer et al. | Aug 2005 | A1 |
| 20050171599 | White | Aug 2005 | A1 |
| 20050177132 | Lentz et al. | Aug 2005 | A1 |
| 20050177222 | Mead | Aug 2005 | A1 |
| 20050177224 | Fogarty et al. | Aug 2005 | A1 |
| 20050203606 | VanCamp | Sep 2005 | A1 |
| 20050216018 | Sennett et al. | Sep 2005 | A1 |
| 20050222649 | Capuano | Oct 2005 | A1 |
| 20050222667 | Hunt | Oct 2005 | A1 |
| 20050222668 | Schaeffer et al. | Oct 2005 | A1 |
| 20050222669 | Purdy | Oct 2005 | A1 |
| 20050228480 | Douglas et al. | Oct 2005 | A1 |
| 20050234542 | Melsheimer | Oct 2005 | A1 |
| 20050266042 | Tseng | Dec 2005 | A1 |
| 20050273155 | Bahler et al. | Dec 2005 | A1 |
| 20050283188 | Loshakove et al. | Dec 2005 | A1 |
| 20060015170 | Jones et al. | Jan 2006 | A1 |
| 20060030911 | Letort | Feb 2006 | A1 |
| 20060030921 | Chu | Feb 2006 | A1 |
| 20060052799 | Middleman et al. | Mar 2006 | A1 |
| 20060069426 | Weinberger | Mar 2006 | A1 |
| 20060095104 | Magers et al. | May 2006 | A1 |
| 20060095114 | Hartley et al. | May 2006 | A1 |
| 20060100684 | Elliott | May 2006 | A1 |
| 20060106406 | Weinberger | May 2006 | A1 |
| 20060116748 | Kaplan et al. | Jun 2006 | A1 |
| 20060142703 | Carter et al. | Jun 2006 | A1 |
| 20060142836 | Hartley et al. | Jun 2006 | A1 |
| 20060149360 | Schwammenthal et al. | Jul 2006 | A1 |
| 20060155358 | LaDuca et al. | Jul 2006 | A1 |
| 20060155359 | Watson | Jul 2006 | A1 |
| 20060155366 | LaDuca et al. | Jul 2006 | A1 |
| 20060167476 | Burdulis, Jr. et al. | Jul 2006 | A1 |
| 20060173528 | Feld et al. | Aug 2006 | A1 |
| 20060173530 | Das | Aug 2006 | A1 |
| 20060178733 | Pinchuk et al. | Aug 2006 | A1 |
| 20060190070 | Dieck et al. | Aug 2006 | A1 |
| 20060193892 | Furst et al. | Aug 2006 | A1 |
| 20060212113 | Shaolian et al. | Sep 2006 | A1 |
| 20060229709 | Morris et al. | Oct 2006 | A1 |
| 20060241740 | Vardi et al. | Oct 2006 | A1 |
| 20060271166 | Thill et al. | Nov 2006 | A1 |
| 20060276882 | Case et al. | Dec 2006 | A1 |
| 20060281966 | Peacock, III | Dec 2006 | A1 |
| 20070016281 | Melsheimer | Jan 2007 | A1 |
| 20070021822 | Boatman | Jan 2007 | A1 |
| 20070027526 | Demetriades et al. | Feb 2007 | A1 |
| 20070043425 | Hartley et al. | Feb 2007 | A1 |
| 20070050011 | Klein | Mar 2007 | A1 |
| 20070055326 | Farley et al. | Mar 2007 | A1 |
| 20070055350 | Erickson et al. | Mar 2007 | A1 |
| 20070055358 | Krolik et al. | Mar 2007 | A1 |
| 20070055360 | Hanson et al. | Mar 2007 | A1 |
| 20070060989 | Deem et al. | Mar 2007 | A1 |
| 20070061002 | Paul, Jr. | Mar 2007 | A1 |
| 20070067014 | Ke et al. | Mar 2007 | A1 |
| 20070073373 | Bonsignore | Mar 2007 | A1 |
| 20070088425 | Schaeffer | Apr 2007 | A1 |
| 20070106368 | Vonderwalde | May 2007 | A1 |
| 20070112344 | Keilman | May 2007 | A1 |
| 20070135677 | Miller et al. | Jun 2007 | A1 |
| 20070135904 | Eidenschink | Jun 2007 | A1 |
| 20070142896 | Anderson et al. | Jun 2007 | A1 |
| 20070150051 | Arnault de la et al. | Jun 2007 | A1 |
| 20070156167 | Connors et al. | Jul 2007 | A1 |
| 20070162104 | Frid | Jul 2007 | A1 |
| 20070167898 | Peters et al. | Jul 2007 | A1 |
| 20070167955 | Arnault De La Menardiere et al. | Jul 2007 | A1 |
| 20070168013 | Douglas | Jul 2007 | A1 |
| 20070168018 | Amplatz | Jul 2007 | A1 |
| 20070179598 | Duerig | Aug 2007 | A1 |
| 20070185565 | Schwammenthal et al. | Aug 2007 | A1 |
| 20070208410 | Berra et al. | Sep 2007 | A1 |
| 20070213805 | Schaeffer et al. | Sep 2007 | A1 |
| 20070213807 | Roubin | Sep 2007 | A1 |
| 20070219610 | Israel | Sep 2007 | A1 |
| 20070219614 | Hartley | Sep 2007 | A1 |
| 20070219627 | Chu | Sep 2007 | A1 |
| 20070225797 | Krivoruhko | Sep 2007 | A1 |
| 20070233220 | Greenan | Oct 2007 | A1 |
| 20070233229 | Berra et al. | Oct 2007 | A1 |
| 20070237973 | Purdy et al. | Oct 2007 | A1 |
| 20070239256 | Weber et al. | Oct 2007 | A1 |
| 20070244542 | Greenan et al. | Oct 2007 | A1 |
| 20070244543 | Mitchell | Oct 2007 | A1 |
| 20070244547 | Greenan | Oct 2007 | A1 |
| 20070250154 | Greenberg | Oct 2007 | A1 |
| 20070255388 | Rudakov et al. | Nov 2007 | A1 |
| 20080002871 | Gunzert-Marx et al. | Jan 2008 | A1 |
| 20080015673 | Chuter | Jan 2008 | A1 |
| 20080015682 | Majercak et al. | Jan 2008 | A1 |
| 20080033527 | Nunez et al. | Feb 2008 | A1 |
| 20080058918 | Watson | Mar 2008 | A1 |
| 20080064957 | Spence | Mar 2008 | A1 |
| 20080086193 | Thramann | Apr 2008 | A1 |
| 20080097578 | Erickson et al. | Apr 2008 | A1 |
| 20080109058 | Greenberg et al. | May 2008 | A1 |
| 20080109066 | Quinn | May 2008 | A1 |
| 20080114444 | Yu | May 2008 | A1 |
| 20080114445 | Melsheimer et al. | May 2008 | A1 |
| 20080114446 | Hartley et al. | May 2008 | A1 |
| 20080140178 | Rasmussen et al. | Jun 2008 | A1 |
| 20080147173 | McIff et al. | Jun 2008 | A1 |
| 20080167704 | Wright et al. | Jul 2008 | A1 |
| 20080176271 | Silver et al. | Jul 2008 | A1 |
| 20080195190 | Bland et al. | Aug 2008 | A1 |
| 20080195191 | Luo | Aug 2008 | A1 |
| 20080215134 | Lawrence-Brown | Sep 2008 | A1 |
| 20080249598 | Sherry | Oct 2008 | A1 |
| 20080262595 | Chu et al. | Oct 2008 | A1 |
| 20080262598 | Elmaleh | Oct 2008 | A1 |
| 20080269789 | Eli | Oct 2008 | A1 |
| 20080275540 | Wen | Nov 2008 | A1 |
| 20080275542 | LaDuca et al. | Nov 2008 | A1 |
| 20080288044 | Osborne | Nov 2008 | A1 |
| 20080294234 | Hartley et al. | Nov 2008 | A1 |
| 20080300665 | Lootz | Dec 2008 | A1 |
| 20080312732 | Hartley et al. | Dec 2008 | A1 |
| 20080319528 | Yribarren et al. | Dec 2008 | A1 |
| 20090005863 | Goetz et al. | Jan 2009 | A1 |
| 20090012597 | Doig et al. | Jan 2009 | A1 |
| 20090012602 | Quadri | Jan 2009 | A1 |
| 20090030497 | Metcalf et al. | Jan 2009 | A1 |
| 20090030502 | Sun et al. | Jan 2009 | A1 |
| 20090048663 | Greenberg | Feb 2009 | A1 |
| 20090054967 | Das | Feb 2009 | A1 |
| 20090062899 | Dang | Mar 2009 | A1 |
| 20090069881 | Chalekian et al. | Mar 2009 | A1 |
| 20090069882 | Venturelli | Mar 2009 | A1 |
| 20090082841 | Zacharias | Mar 2009 | A1 |
| 20090082847 | Zacharias et al. | Mar 2009 | A1 |
| 20090099640 | Weng | Apr 2009 | A1 |
| 20090099647 | Glimsdale et al. | Apr 2009 | A1 |
| 20090099648 | Yu | Apr 2009 | A1 |
| 20090099649 | Chobotov et al. | Apr 2009 | A1 |
| 20090099650 | Bolduc et al. | Apr 2009 | A1 |
| 20090105809 | Lee et al. | Apr 2009 | A1 |
| 20090112233 | Xiao | Apr 2009 | A1 |
| 20090125096 | Chu et al. | May 2009 | A1 |
| 20090138067 | Pinchuk et al. | May 2009 | A1 |
| 20090149877 | Hanson et al. | Jun 2009 | A1 |
| 20090157014 | Osborne et al. | Jun 2009 | A1 |
| 20090164001 | Biggs et al. | Jun 2009 | A1 |
| 20090171437 | Brocker et al. | Jul 2009 | A1 |
| 20090182270 | Nanavati | Jul 2009 | A1 |
| 20090182405 | Amault De La Menardiere et al. | Jul 2009 | A1 |
| 20090227997 | Wang | Sep 2009 | A1 |
| 20090240316 | Bruszewski | Sep 2009 | A1 |
| 20090248134 | Dierking et al. | Oct 2009 | A1 |
| 20090254170 | Hartley et al. | Oct 2009 | A1 |
| 20090259290 | Bruszewski et al. | Oct 2009 | A1 |
| 20090287145 | Cragg et al. | Nov 2009 | A1 |
| 20090319022 | Hartley et al. | Dec 2009 | A1 |
| 20100004728 | Rao | Jan 2010 | A1 |
| 20100029608 | Finley | Feb 2010 | A1 |
| 20100057186 | West et al. | Mar 2010 | A1 |
| 20100063575 | Shalev | Mar 2010 | A1 |
| 20100070019 | Shalev | Mar 2010 | A1 |
| 20100082091 | Berez | Apr 2010 | A1 |
| 20100161025 | Kuppurathanam et al. | Jun 2010 | A1 |
| 20100161026 | Brocker et al. | Jun 2010 | A1 |
| 20100161028 | Chuter et al. | Jun 2010 | A1 |
| 20100168838 | Hartley et al. | Jul 2010 | A1 |
| 20100211159 | Schmid | Aug 2010 | A1 |
| 20100249899 | Chuter et al. | Sep 2010 | A1 |
| 20100256725 | Rasmussen | Oct 2010 | A1 |
| 20100262227 | Rangwala et al. | Oct 2010 | A1 |
| 20100268327 | Bruszewski et al. | Oct 2010 | A1 |
| 20100274187 | Argentine | Oct 2010 | A1 |
| 20100274345 | Rust | Oct 2010 | A1 |
| 20100292774 | Shalev | Nov 2010 | A1 |
| 20100312326 | Chuter et al. | Dec 2010 | A1 |
| 20100318171 | Porter | Dec 2010 | A1 |
| 20100318180 | Porter | Dec 2010 | A1 |
| 20110022149 | Cox et al. | Jan 2011 | A1 |
| 20110022153 | Schreck et al. | Jan 2011 | A1 |
| 20110040366 | Goetz et al. | Feb 2011 | A1 |
| 20110093002 | Rucker et al. | Apr 2011 | A1 |
| 20110125251 | Cottone | May 2011 | A1 |
| 20110152998 | Berez et al. | Jun 2011 | A1 |
| 20110208289 | Shalev | Aug 2011 | A1 |
| 20110208296 | Duffy et al. | Aug 2011 | A1 |
| 20110208297 | Tuval et al. | Aug 2011 | A1 |
| 20110208298 | Tuval et al. | Aug 2011 | A1 |
| 20110218607 | Arbefeuille et al. | Sep 2011 | A1 |
| 20110218609 | Chobotov et al. | Sep 2011 | A1 |
| 20110218617 | Nguyen et al. | Sep 2011 | A1 |
| 20110319983 | Zhu et al. | Sep 2011 | A1 |
| 20110257720 | Peterson et al. | Oct 2011 | A1 |
| 20110257725 | Argentine et al. | Oct 2011 | A1 |
| 20110262684 | Wintsch et al. | Oct 2011 | A1 |
| 20110264184 | Heltai | Oct 2011 | A1 |
| 20110264192 | Hartley et al. | Oct 2011 | A1 |
| 20110270385 | Muzslay | Nov 2011 | A1 |
| 20110288622 | Chan et al. | Nov 2011 | A1 |
| 20110301702 | Rust et al. | Dec 2011 | A1 |
| 20120143317 | Cam et al. | Jun 2012 | A1 |
| 20120150274 | Shalev et al. | Jun 2012 | A1 |
| 20120158038 | Leschinsky | Jun 2012 | A1 |
| 20120172929 | Shalev | Jul 2012 | A1 |
| 20120172965 | Kratzberg et al. | Jul 2012 | A1 |
| 20120179236 | Benary et al. | Jul 2012 | A1 |
| 20120185031 | Ryan et al. | Jul 2012 | A1 |
| 20120271401 | Bruszewski et al. | Oct 2012 | A1 |
| 20120310324 | Benary et al. | Dec 2012 | A1 |
| 20120316634 | Shalev et al. | Dec 2012 | A1 |
| 20120323305 | Benary et al. | Dec 2012 | A1 |
| 20120330399 | Shalev et al. | Dec 2012 | A1 |
| 20130013050 | Shalev et al. | Jan 2013 | A1 |
| 20130013051 | Benary | Jan 2013 | A1 |
| 20130035751 | Shalev | Feb 2013 | A1 |
| 20130090722 | Shalev et al. | Apr 2013 | A1 |
| 20130116773 | Roeder et al. | May 2013 | A1 |
| 20130116775 | Roeder et al. | May 2013 | A1 |
| 20130131783 | Shalev et al. | May 2013 | A1 |
| 20130158646 | Roeder | Jun 2013 | A1 |
| 20130197454 | Shibata et al. | Aug 2013 | A1 |
| 20130204311 | Kunis | Aug 2013 | A1 |
| 20130204343 | Shalev | Aug 2013 | A1 |
| 20130261994 | Raz et al. | Oct 2013 | A1 |
| 20130274866 | Cox et al. | Oct 2013 | A1 |
| 20130289587 | Shalev | Oct 2013 | A1 |
| 20130289691 | Argentine | Oct 2013 | A1 |
| 20130297005 | Shalev | Nov 2013 | A1 |
| 20130338753 | Geusen | Dec 2013 | A1 |
| 20130338787 | Hopkins et al. | Dec 2013 | A1 |
| 20140005764 | Schroeder | Jan 2014 | A1 |
| 20140052236 | Shalev | Feb 2014 | A1 |
| 20140148888 | Barrand | May 2014 | A1 |
| 20140172072 | Shalev | Jun 2014 | A1 |
| 20140180378 | Roeder | Jun 2014 | A1 |
| 20140288634 | Shalev | Sep 2014 | A1 |
| 20140288635 | Shalev | Sep 2014 | A1 |
| 20140316510 | Berra | Oct 2014 | A1 |
| 20140324154 | Shalev | Oct 2014 | A1 |
| 20140350658 | Benary et al. | Nov 2014 | A1 |
| 20140364930 | Strauss et al. | Dec 2014 | A1 |
| 20150073534 | Roeder et al. | Mar 2015 | A1 |
| 20150105851 | Shalev et al. | Apr 2015 | A1 |
| 20150142096 | Shalev | May 2015 | A1 |
| 20150196301 | Bodewadt et al. | Jul 2015 | A1 |
| 20150202065 | Shalev et al. | Jul 2015 | A1 |
| 20150351943 | Shalev et al. | Dec 2015 | A1 |
| 20150374383 | Bodewadt et al. | Dec 2015 | A1 |
| 20160030209 | Shalev et al. | Feb 2016 | A1 |
| 20160157990 | Shalev et al. | Jun 2016 | A1 |
| 20160193029 | Shalev | Jul 2016 | A1 |
| 20160262880 | Li et al. | Sep 2016 | A1 |
| Number | Date | Country |
|---|---|---|
| 2 497 704 | Mar 2004 | CA |
| 1194577 | Sep 1998 | CN |
| 2453960 | Oct 2001 | CN |
| 1748660 | Mar 2006 | CN |
| 2817770 | Sep 2006 | CN |
| 101045022 | Oct 2007 | CN |
| 201058061 | May 2008 | CN |
| 101980670 | Feb 2011 | CN |
| 101998845 | Mar 2011 | CN |
| 10213055 | Sep 2002 | DE |
| 0893108 | Jan 1999 | EP |
| 1 177 779 | Feb 2002 | EP |
| 1 177 780 | Feb 2002 | EP |
| 1 325 716 | Jul 2003 | EP |
| 1470797 | Oct 2004 | EP |
| 1759666 | Mar 2007 | EP |
| 1961401 | Aug 2008 | EP |
| 2266509 | Dec 2010 | EP |
| 2298248 | Mar 2011 | EP |
| 2000-279533 | Oct 2000 | JP |
| 2002-253682 | Sep 2002 | JP |
| 1996039104 | Dec 1996 | WO |
| 9806355 | Feb 1998 | WO |
| 1998027895 | Jul 1998 | WO |
| 9913808 | Mar 1999 | WO |
| 1999025273 | May 1999 | WO |
| 9934748 | Jul 1999 | WO |
| 1999051165 | Oct 1999 | WO |
| 0028923 | May 2000 | WO |
| 2000074595 | Dec 2000 | WO |
| 2000076423 | Dec 2000 | WO |
| 2002083038 | Oct 2002 | WO |
| 2003034948 | May 2003 | WO |
| 03099108 | Dec 2003 | WO |
| 2004017868 | Mar 2004 | WO |
| 2004045463 | Jun 2004 | WO |
| 2004100836 | Nov 2004 | WO |
| 05002466 | Jan 2005 | WO |
| 2005034809 | Apr 2005 | WO |
| 2005037138 | Apr 2005 | WO |
| 2005041781 | May 2005 | WO |
| 2005041783 | May 2005 | WO |
| 2005046524 | May 2005 | WO |
| 2005046526 | May 2005 | WO |
| 2006007389 | Jan 2006 | WO |
| 2006028925 | Mar 2006 | WO |
| 2006036690 | Apr 2006 | WO |
| 06070372 | Jul 2006 | WO |
| 2006088905 | Aug 2006 | WO |
| 2006130755 | Dec 2006 | WO |
| 2007022495 | Feb 2007 | WO |
| 2007039587 | Apr 2007 | WO |
| 2007084547 | Jul 2007 | WO |
| 2007115017 | Oct 2007 | WO |
| 2007144782 | Dec 2007 | WO |
| 08008291 | Jan 2008 | WO |
| 2008021557 | Feb 2008 | WO |
| 2008035337 | Mar 2008 | WO |
| 2008042266 | Apr 2008 | WO |
| 2008047092 | Apr 2008 | WO |
| 2008047354 | Apr 2008 | WO |
| 2008051704 | May 2008 | WO |
| 2008053469 | May 2008 | WO |
| 2008066923 | Jun 2008 | WO |
| 2008107885 | Sep 2008 | WO |
| 2008140796 | Nov 2008 | WO |
| 2009078010 | Jun 2009 | WO |
| 2009082444 | Jul 2009 | WO |
| 2009104000 | Aug 2009 | WO |
| 2009116041 | Sep 2009 | WO |
| 2009116042 | Sep 2009 | WO |
| 09118733 | Oct 2009 | WO |
| 2010024869 | Mar 2010 | WO |
| 2010024879 | Mar 2010 | WO |
| 2010027704 | Mar 2010 | WO |
| 2010031060 | Mar 2010 | WO |
| 2010042210 | Apr 2010 | WO |
| 2010045238 | Apr 2010 | WO |
| 2010062355 | Jun 2010 | WO |
| 10088776 | Aug 2010 | WO |
| 2010111583 | Sep 2010 | WO |
| 2010128162 | Nov 2010 | WO |
| 2010150208 | Dec 2010 | WO |
| 2011004374 | Jan 2011 | WO |
| 2011007354 | Jan 2011 | WO |
| 2011055364 | May 2011 | WO |
| 2011064782 | Jun 2011 | WO |
| 2011067764 | Jun 2011 | WO |
| 2011070576 | Jun 2011 | WO |
| 2001052776 | Jul 2011 | WO |
| 2011080738 | Jul 2011 | WO |
| 2011095979 | Aug 2011 | WO |
| 2011100290 | Aug 2011 | WO |
| 2011106532 | Sep 2011 | WO |
| 2011106533 | Sep 2011 | WO |
| 2011106544 | Sep 2011 | WO |
| 2011116307 | Sep 2011 | WO |
| 2011136930 | Nov 2011 | WO |
| 2012039748 | Mar 2012 | WO |
| 2012049679 | Apr 2012 | WO |
| 2012104842 | Aug 2012 | WO |
| 2012111006 | Aug 2012 | WO |
| 2012117395 | Sep 2012 | WO |
| 2012176187 | Dec 2012 | WO |
| 2013005207 | Jan 2013 | WO |
| 2013021374 | Feb 2013 | WO |
| 2013030818 | Mar 2013 | WO |
| 2013030819 | Mar 2013 | WO |
| 2013065040 | May 2013 | WO |
| 2013069019 | May 2013 | WO |
| 2013084235 | Jun 2013 | WO |
| 2013171730 | Nov 2013 | WO |
| 2014020609 | Feb 2014 | WO |
| 2014108895 | Jul 2014 | WO |
| 2014141232 | Sep 2014 | WO |
| 2014188412 | Nov 2014 | WO |
| Entry |
|---|
| An Office Action dated Jul. 17, 2017, which issued during the prosecution of U.S. Appl. No. 14/759,736. |
| “E-vita® open plus” product brochure (JOTEC GmbH, Hechingen, Germany), 2010. |
| Fonseca A et al., “Intravascular ultrasound assessment of the novel AngioSculpt scoring balloon catheter for the treatment of complex coronary lesions,” J Invasive Cardiol 20(1):21-7 (Jan. 2008). |
| Khlif H et al., “Contribution to the Improvement of Textile Vascular Prostheses Crimping,” Trends in Applied Sciences Research 6(9):1019-1027 (2011). |
| An International Search Report dated Sep. 29, 2008, which issued during the prosecution of Applicant's PCT/IL08/000287. |
| A Written Opinion dated Sep. 29, 2008, which issued during the prosecution of Applicant's PCT/IL08/000287. |
| An International Search Report & Written Opinion both dated Nov. 26, 2013, which issued during the prosecution of Applicant's PCT/IL2013/050656. |
| An International Search Report dated Feb. 4, 2011, which issued during the prosecution of Applicant's PCT/IB2010/052861. |
| A Written Opinion dated Feb. 4, 2011, which issued during the prosecution of Applicant's PCT/IB2010/052861. |
| An International Search Report dated Dec. 3, 2010, which issued during the prosecution of Applicant's PCT/IL2010/000564. |
| A Written Opinion dated Dec. 3, 2010, which issued during the prosecution of Applicant's PCT/IL2010/000564. |
| An International Search Report dated Nov. 5, 2010, which issued during the prosecution of Applicant's PCT/IL2010/000549. |
| A Written Opinion dated Nov. 5, 2010, which issued during the prosecution of Applicant's PCT/IL2010/000549. |
| An International Search Report dated Aug. 4, 2011, which issued during the prosecution of Applicant's PCT/IL2010/000999. |
| An International Search Report dated Mar. 10, 2011, which issued during the prosecution of Applicant's PCT/IL2010/000917. |
| An International Search Report together with Written Opinion both dated Mar. 30 2011, which issued during the prosecution of Applicant's PCT/IL2010/001018. |
| An International Search Report dated Apr. 18, 2011, which issued during the prosecution of Applicant's PCT/IL2010/001037. |
| An International Search Report dated May 23, 2011, which issued during the prosecution of Applicant's PCT/IL2010/001087. |
| An International Search Report dated Jun. 28, 2011, which issued during the prosecution of Applicant's PCT/IL2011/000135. |
| An International Search Report dated Jun. 30, 2009, which issued during the prosecution of Applicant's PCT/IL2008/001621. |
| A Written Opinion dated Jun. 30, 2009, which issued during the prosecution of Applicant's PCT/IL2008/001621. |
| An International Search Report dated Mar. 11, 2009, which issued during the prosecution of Applicant's PCT/IL2007/001312. |
| A Written Opinion dated Mar. 11, 2009, which issued during the prosecution of Applicant's PCT/IL2007/001312. |
| An English translation of an Office Action dated Aug. 25, 2011, which issued during the prosecution of Chinese Patent Application No. 200880014919.9. |
| An Office Action dated Nov. 12, 2010, which issued during the prosecution of U.S. Appl. No. 12/447,684. |
| An Office Action dated Apr. 27, 2011, which issued during the prosecution of U.S. Appl. No. 12/447,684. |
| An Office Action dated Feb. 25, 2013, which issued during the prosecution of U.S. Appl. No. 13/031,871. |
| An Office Action dated Feb. 27, 2013, which issued during the prosecution of U.S. Appl. No. 12/808,037. |
| An Extended European Search Report dated Dec. 13, 2012, which issued during the prosecution of Applicant's European App No. 08719912.1. |
| An International Search Report together with Written Opinion both dated Sep. 6, 2012, which issued during the prosecution of Applicant's PCT/IL2012/000190. |
| An International Search Report together with Written Opinion both dated Aug. 31, 2012, which issued during the prosecution of Applicant's PCT/IL2012/000148. |
| An Office Action dated Oct. 11, 2012, which issued during the prosecution of U.S. Appl. No. 13/031,871. |
| An Office Action dated Jun. 19, 2012, which issued during the prosecution of U.S. Appl. No. 12/808,037. |
| An International Search Report together with Written Opinion both dated Sep. 24, 2012, which issued during the prosecution of Applicant's PCT/IL2012/000060. |
| An International Search Report together with Written Opinion both dated Oct. 1, 2012, which issued during the prosecution of Applicant's PCT/IL2012/000241. |
| An International Search Report together with Written Opinion both dated Oct. 4, 2012, which issued during the prosecution of Applicant's PCT/IL2012/000269. |
| An International Search Report together with Written Opinion both dated Nov. 27, 2012, which issued during the prosecution of Applicant's PCT/IL2012/000300. |
| An Office Action dated Jul. 22, 2016, which issued during the prosecution of Chinese Patent Application No. 201480012648.9. |
| An Office Action dated Oct. 28, 2011, which issued during the prosecution of U.S. Appl. No. 12/529,936. |
| An Office Action dated Mar. 24, 2011, which issued during the prosecution of U.S. Appl. No. 12/529,936. |
| An International Search Report and a Written Opinion both dated Jun. 14, 2013, which issued during the prosecution of Applicant's PCT/IL2012/050506. |
| Van Prehn J et al., “Oversizing of aortic stent grafts for abdominal aneurysm repair: a systematic review of the benefits and risks,” Eur J Vase Endovase Surg. Jul. 2009;38(1):42-53. Epub May 9, 2009 (abstract only). |
| Fattori et al., Degenerative aneurysm of the descending aorta. Endovascular Treatment. pp. 1-11, 2007, European Association for Cardio-Thoracic Surgery. |
| An Office Action dated Jan. 12, 2016, which issued during the prosecution of U.S. Appl. No. 14/362,194. |
| European Search Report dated Aug. 31, 2016, which issued during the prosecution of Applicant's European App No. 14762507.3. |
| An Office Action dated Feb. 5, 2015, which issued during the prosecution of U.S. Appl. No. 13/384,075. |
| An Office Action dated Feb. 23, 2015, which issued during the prosecution of U.S. Appl. No. 13/513,397. |
| European Search Report dated Feb. 26, 2015, which issued during the prosecution of Applicant's European App No. 12806964.8. |
| An International Search Report and a Written Opinion both dated Mar. 18, 2015, which issued during the prosecution of Applicant's PCT/IL2014/050973. |
| An English translation of an Office Action dated Mar. 19, 2015, which issued during the prosecution of Chinese Patent Application No. 201080036970.7. |
| An English translation of an Office Action dated Oct. 8, 2014, which issued during the prosecution of Chinese Patent Application No. 201080036970.7. |
| European Search Report dated May 23, 2016, which issued during the prosecution of Applicant's European App No. 10832752.9. |
| An Office Action dated Mar. 26, 2015, which issued during the prosecution of U.S. Appl. No. 13/514,240. |
| European Search Report dated Mar. 20, 2015, which issued during the prosecution of Applicant's European App No. 08861980.4. |
| An International Search Report and a Written Opinion both dated Jun. 21, 2016, which issued during the prosecution of Applicant's PCT/IL2016/050014. |
| An Office Action dated Aug. 12, 2015, which issued during the prosecution of U.S. Appl. No. 13/513,397. |
| European Search Report dated Sep. 22, 2016, which issued during the prosecution of Applicant's European App No. 10834308.8. |
| An Office Action dated Aug. 3, 2016, which issued during the prosecution of U.S. Appl. No. 14/241,793. |
| An Office Action dated Sep. 22, 2016, which issued during the prosecution of Canadian Patent Application No. 2,782,513. |
| An Office Action dated Sep. 23, 2015, which issued during the prosecution of U.S. Appl. No. 13/384,075. |
| An Office Action dated Oct. 2, 2015, which issued during the prosecution of U.S. Appl. No. 13/577,161. |
| European Search Report dated Apr. 22, 2015, which issued during the prosecution of Applicant's European App No. 12828495.7. |
| An Office Action dated Apr. 14, 2015, which issued during the prosecution of U.S. Appl. No. 14/130,213. |
| European Search Report dated Jan. 18, 2016 which issued during the prosecution of Applicant's European App No. 10799521.9. |
| European Search Report dated Oct. 27, 2015 which issued during the prosecution of Applicant's European App No. 10835608.0. |
| An Office Action dated Feb. 23, 2016, which issued during the prosecution of U.S. Appl. No. 14/416,236. |
| An Office Action dated Mar. 7, 2016, which issued during the prosecution of U.S. Appl. No. 14/240,600. |
| An Office Action dated Feb. 1, 2016, which issued during the prosecution of U.S. Appl. No. 14/241,793. |
| An Office Action dated Feb. 19, 2016, which issued during the prosecution of U.S. Appl. No. 13/807,880. |
| An International Search Report and a Written Opinion both dated Feb. 17, 2016, which issued during the prosecution of Applicant's PCT/IL2015/051221. |
| European Search Report dated Mar. 11, 2016 which issued during the prosecution of Applicant's European App No. 11739497.3. |
| European Search Report dated Mar. 15, 2016 which issued during the prosecution of Applicant's European App No. 13825456.0. |
| An Office Action dated Mar. 28, 2016, which issued during the prosecution of U.S. Appl. No. 14/362,194. |
| An Invitation to pay additional fees dated Apr. 12, 2016, which issued during the prosecution of Applicant's PCT/IL2016/050014. |
| An International Search Report and a Written Opinion both dated Apr. 22, 2016, which issued during the prosecution of Applicant's PCT/IL2016/050049. |
| Scurr et al., “Fenestrated Aortic Stent Grafts,” Semin Intervent Radiol. Jun. 2007; 24(2): 211-220. |
| European Search Report dated Oct. 27, 2016 whoch issued during the prosecution of Applicant's European App No. 14801036.6. |
| U.S. Appl. No. 61/265,793, filed Dec. 2, 2009. |
| An International Search Report and a Written Opinion both dated Jul. 30, 2014, which issued during the prosecution of Applicant's PCT/IL2014/050174. |
| European Search Report dated Jun. 12, 2014, which issued during the prosecution of Applicant's European App No. 12855964.8. |
| An Office Action dated Feb. 3, 2015, which issued during the prosecution of U.S. Appl. No. 12/447,684. |
| Invitation to Pay Additional Fees dated May 13, 2014, which issued during the prosecution of Applicant's PCT/IL2014/050019. |
| U.S. Appl. No. 61/826,544, filed May 23, 2013. |
| U.S. Appl. No. 61/566,654, filed Dec. 4, 2011. |
| U.S. Appl. No. 61/014,031, filed Dec. 15, 2007. |
| U.S. Appl. No. 61/448,199, filed Mar. 2, 2011. |
| Invitation to Pay Additional Fees dated May 8, 2014, which issued during the prosecution of Applicant's PCT/IL2014/050174. |
| An Office Action dated Mar. 28, 2014, which issued during the prosecution of U.S. Appl. No. 13/519,971. |
| An International Search Report and a Written Opinion both dated Apr. 28, 2014, which issued during the prosecution of Applicant's PCT/IL2014/050019. |
| An Office Action dated Aug. 15, 2014, which issued during the prosecution of U.S. Appl. No. 13/512,778. |
| An Office Action dated Feb. 28, 2014, which issued during the prosecution of U.S. Appl. No. 13/512,778. |
| An Office Action dated Dec. 27, 2016, which issued during the prosecution of Chinese Patent Application No. 201510685240.4. |
| An Office Action dated Dec. 7, 2016, which issued during the prosecution of U.S. Appl. No. 14/400,699. |
| An Office Action dated Jan. 12, 2017, which issued during the prosecution of U.S. Appl. No. 14/518,542. |
| Aortic Aneurysm O'Gara, Patrick T. Circulation. 2003; 107:e43-e45. |
| An International Search Report and a Written Opinion both dated Jan. 19, 2017, which issued during the prosecution of Applicant's PCT/IL2016/051207. |
| An Office Action dated Mar. 6, 2017, which issued during the prosecution of U.S. Appl. No. 13/979,551. |
| An Office Action dated Jan. 26, 2017, which issued during the prosecution of U.S. Appl. No. 14/572,156. |
| Notice of Allowance dated Feb. 9, 2017, which issued during the prosecution of U.S. Appl. No. 14/772,016. |
| An International Preliminary Report on Patentability dated Jan. 7, 2014, which issued during the prosecution of Applicant's PCT/IL2012/000269. |
| An International Preliminary Report on Patentability dated Jan. 4, 2012, which issued during the prosecution of Applicant's PCT/IB2010/052861. |
| An International Preliminary Report on Patentability dated Dec. 23, 2013, which issued during the prosecution of Applicant's PCT/IL2012/000241. |
| An International Preliminary Report on Patentability dated Aug. 6, 2013, which issued during the prosecution of Applicant's PCT/IL2012/000060. |
| U.S. Appl. No. 61/438,977, filed Feb. 3, 2011. |
| Notice of Allowance dated Dec. 19, 2014, which issued during the prosecution of U.S. Appl. No. 13/512,778. |
| An Office Action dated Jul. 30, 2015, which issued during the prosecution of U.S. Appl. No. 14/240,600. |
| An Office Action dated Sep. 11, 2015, which issued during the prosecution of U.S. Appl. No. 14/001,641. |
| An Office Action dated May 15, 2015, which issued during the prosecution of U.S. Appl. No. 13/577,161. |
| An Office Action dated May 28, 2015, which issued during the prosecution of U.S. Appl. No. 14/240,600. |
| An Advisory Action dated Feb. 13, 2014, which issued during the prosecution of U.S. Appl. No. 13/807,880. |
| An Office Action dated May 20, 2013, which issued during the prosecution of U.S. Appl. No. 13/807,880. |
| Notice of Allowance dated Nov. 25, 2016, which issued during the prosecution of U.S. Appl. No. 13/807,880. |
| Notice of Allowance dated Sep. 27, 2016, which issued during the prosecution of U.S. Appl. No. 13/807,880. |
| Notice of Allowance dated Aug. 15, 2016, which issued during the prosecution of U.S. Appl. No. 13/807,880. |
| An Office Action dated Dec. 2, 2013, which issued during the prosecution of U.S. Appl. No. 13/807,880. |
| An Office Action dated Mar. 2, 2016, which issued during the prosecution of Chinese Patent Application No. 201480012648.9. |
| An Office Action dated Jan. 16, 2015, which issued during the prosecution of Chinese Patent Application No. 201080062714.5. |
| An Office Action dated Jun. 3, 2015, which issued during the prosecution of Chinese Patent Application No. 201080062714.5. |
| Notice of Allowance dated Aug. 5, 2015, which issued during the prosecution of Chinese Patent Application No. 201080062714.5. |
| An Office Action dated Jul. 2, 2014, which issued during the prosecution of Chinese Patent Application No. 201080062714.5. |
| Notice of Allowance dated Nov. 7, 2014, which issued during the prosecution of U.S. Appl. No. 13/512,778. |
| Notice of Allowance dated Oct. 8, 2014, which issued during the prosecution of U.S. Appl. No. 13/512,778. |
| An Office Action dated Jun. 18, 2013, which issued during the prosecution of U.S. Appl. No. 13/512,778. |
| Notice of Allowance dated Nov. 10, 2016, which issued during the prosecution of U.S. Appl. No. 14/362,194. |
| European Search Report dated Jun. 30, 2014, which issued during the prosecution of Applicant's European App No. 12741804.4. |
| An International Search Report and a Written Opinion both dated Jul. 17, 2012, which issued during the prosecution of Applicant's PCT/IL2012/000095. |
| An International Search Report and a Written Opinion both dated Jul. 13, 2012, which issued during the prosecution of Applicant's PCT/IL2012/000083. |
| An International Preliminary Report on Patentability dated Sep. 3, 2013, which issued during the prosecution of Applicant's PCT/IL2012/000095. |
| An International Search Report and a Written Opinion both dated Mar. 15, 2013, which issued during the prosecution of Applicant's PCT/IL2012/050424. |
| An English translation of an Office Action dated Jan. 28, 2014, which issued during the prosecution of Chinese Patent Application No. 201080036970.7. |
| An Office Action dated Apr. 28, 2014, which issued during the prosecution of Applicant's U.S. Appl. No. 13/939,798. |
| An Office Action dated Apr. 10, 2014, which issued during the prosecution of Applicant's U.S. Appl. No. 13/807,906. |
| An Office Action dated Apr. 24, 2014, which issued during the prosecution of Applicant's U.S. Appl. No. 13/380,278. |
| Supplementary European Search Report dated Feb. 17, 2014, which issued during the prosecution of Applicant's European App No. 12803376.8. |
| An Office Action dated Jul. 24, 2014, which issued during the prosecution of Canadian Patent Application No. 2768228. |
| U.S. Appl. No. 61/264,861, filed Nov. 30, 2009. |
| An Interview Summary dated Sep. 25, 2014, which issued during the prosecution of U.S. Appl. No. 13/512,778. |
| An Interview Summary dated Apr. 24, 2014, which issued during the prosecution of U.S. Appl. No. 13/512,778. |
| Ryhanen J., in “Biocompatibility evaluation of nickel-titanium shape memory metal alloy,” Academic Dissertation, Faculty of Medicine, Department of Surgery, University of Oulu, Finland (May 1999). |
| An Office action dated Sep. 4, 2014, from the U.S. Patent and Trademark Office in counterpart U.S. Appl. No. 13/519,971. |
| An Office action dated Dec. 9, 2015, from the U.S. Patent and Trademark Office in counterpart U.S. Appl. No. 14/416,236. |
| An Office Action dated Apr. 14, 2016, which issued during the prosecution of Canadian Patent Application No. 2,766,347. |
| An Office Action dated Sep. 15, 2016, which issued during the prosecution of Canadian Patent Application No. 2,782,357. |
| European Office Action dated Dec. 17, 2014 in European Patent Application No. 12803376.8. |
| International Preliminary Report on Patentability dated Jan. 12, 2010 in corresponding International Application No. PCT/IL2008/000287. |
| U.S. Appl. No. 61/906,014, filed Nov. 19, 2013. |
| U.S. Appl. No. 61/775,964, filed Mar. 11, 2013. |
| U.S. Appl. No. 61/926,533, filed Jan. 13, 2014. |
| U.S. Appl. No. 61/528,242, filed Aug. 28, 2011. |
| An Office action dated Aug. 15, 2014, from the U.S. Patent and Trademark Office in counterpart U.S. Appl. No. 13/939,798. |
| A Notice of Allowance dated Jan. 20, 2015, which issued during the prosecution of U.S. Appl. No. 13/383,128. |
| An International Preliminary Report on Patentability dated Feb. 3, 2015, which issued during the prosecution of Applicant's PCT/IL2013/050656. |
| A Notice of Allowance dated Jan. 7, 2014, which issued during the prosecution of U.S. Appl. No. 13/663,117. |
| An Office Action dated Sep. 2, 2014, which issued during the prosecution of U.S. Appl. No. 12/447,684. |
| European Search Report dated Oct. 31, 2014, which issued during the prosecution of Applicant's European App No. 12752054.2. |
| Notice of allowance dated Jun. 24, 2014, which issued during the prosecution of Applicant's U.S. Appl. No. 13/380,278. |
| An Interview Summary dated Dec. 13, 2010, which issued during the prosecution of U.S. Appl. No. 12/447,684. |
| An Office Action dated Mar. 21, 2012, which issued during the prosecution of U.S. Appl. No. 12/808,037. |
| Notice of allowance dated May 22, 2013, which issued during the prosecution of U.S. Appl. No. 12/808,037. |
| An English translation of an Office Action dated Nov. 28, 2013, which issued during the prosecution of Chinese Patent Application No. 200880126889.0. |
| An English translation of an Office Action dated May 16, 2014, which issued during the prosecution of Chinese Patent Application No. 200880126889.0. |
| An English translation of an Office Action dated Feb. 16, 2013, which issued during the prosecution of Chinese Patent Application No. 200880126889.0. |
| A Notice of Allowance dated Aug. 2, 2012, which issued during the prosecution of U.S. Appl. No. 12/529,936. |
| An International Preliminary Report on Patentability dated Jan. 10, 2012, which issued during the prosecution of Applicant's PCT/IL2010/000549. |
| An International Preliminary Report on Patentability dated Jan. 17, 2012, which issued during the prosecution of Applicant's PCT/IL2010/000564. |
| An International Preliminary Report on Patentability dated Jun. 5, 2012, which issued during the prosecution of Applicant's PCT/IL2010/000999. |
| An International Preliminary Report on Patentability dated Jun. 5, 2012, which issued during the prosecution of Applicant's PCT/IL2010/001018. |
| An International Preliminary Report on Patentability dated Jun. 10, 2014, which issued during the prosecution of Applicant's PCT/IL2012/050506. |
| A Notice of Allowance issued in U.S. Appl. No. 13/807,906 dated Oct. 10, 2014. |
| A Restriction Requirement dated Jan. 29, 2014, which issued during the prosecution of U.S. Appl. No. 13/519,971. |
| An International Preliminary Report on Patentability dated Jun. 12, 2012, which issued during the prosecution of Applicant's PCT/IL2010/001037. |
| An International Preliminary Report on Patentability dated Mar. 4, 2014, which issued during the prosecution of Applicant's PCT/IL2012/000300. |
| An International Preliminary Report on Patentability dated May 6, 2014, which issued during the prosecution of Applicant's PCT/IL2012/050424. |
| An International Preliminary Report on Patentability dated May 8, 2012, which issued during the prosecution of Applicant's PCT/IL2010/000917. |
| An International Preliminary Report on Patentability dated Nov. 18, 2014, which issued during the prosecution of Applicant's PCT/IL2012/000190. |
| International Preliminary Report on Patentability dated Aug. 21, 2013 in corresponding International Application No. PCT/IL2012/000083. |
| An International Search Report dated Nov. 28, 2014, which issued during the prosecution of Applicant's PCT/IL2014/050434. |
| An Interview Summary dated Feb. 28, 2012, which issued during the prosecution of U.S. Appl. No. 12/529,936. |
| An Office Action dated Jul. 28, 2014, which issued during the prosecution of U.S. Appl. No. 13/031,871. |
| U.S. Appl. No. 61/678,182, filed Aug. 1, 2012. |
| U.S. Appl. No. 61/529,931, filed Sep. 1, 2011. |
| An Office Action dated Nov. 3, 2014, which issued during the prosecution of Canadian Patent Application No. 2767596. |
| Notice of Allowance dated Jun. 18, 2013, which issued during the prosecution of U.S. Appl. No. 13/523,296. |
| Office Action dated Oct. 27, 2014 in Canadian Patent Application No. 2,785,953. |
| An Office Action dated Nov. 19, 2013, which issued during the prosecution of U.S. Appl. No. 13/663,117. |
| U.S. Appl. No. 61/553,209, filed Oct. 30, 2011. |
| U.S. Appl. No. 61/499,195, filed Jun. 21, 2011. |
| U.S. Appl. No. 61/749,965, filed Jan. 8, 2013. |
| U.S. Appl. No. 61/505,132, filed Jul. 7, 2011. |
| U.S. Appl. No. 61/496,613, filed Jun. 14, 2011. |
| U.S. Appl. No. 61/221,074, filed Jun. 28, 2009. |
| U.S. Appl. No. 61/219,758, filed Jun. 23, 2009. |
| Number | Date | Country | |
|---|---|---|---|
| 20160302950 A1 | Oct 2016 | US |
| Number | Date | Country | |
|---|---|---|---|
| 61926533 | Jan 2014 | US | |
| 61906014 | Nov 2013 | US |
