Prosthesis delivery device with a pusher extension and an extension dilator

Patent metadata

Field	Value
Publication number	US-10376398-B2
Application number	US-201615044558-A
Country	US
Kind code	B2
Filing date	Feb 16, 2016
Priority date	Mar 13, 2015
Publication date	Aug 13, 2019
Grant date	Aug 13, 2019

Abstract

A delivery device and methods for deploying an endovascular prosthesis within the common and internal iliac arteries are described. The device comprises a pusher catheter having a proximal end and a pusher extension extending proximally therefrom. A tubular prosthesis having a side branch is releasably coupled to the pusher extension. An extension dilator extends proximally from the proximal end of the pusher catheter, extends at least partially along an external surface of the main tubular body, into a distal end of the side branch and exits a proximal end of the tubular prosthesis. The extension dilator can be tracked over a guide wire which serves to both position the device within a vessel and also to facilitate cannulation of an internal iliac artery.

First claim

The invention claimed is:

1. A prosthesis delivery device comprising:
a pusher catheter having a proximal end, a distal end and a lumen extending there between;
a pusher extension extending proximally from the proximal end of the pusher catheter;
a tubular prosthesis releasably coupled to the pusher extension, wherein the tubular prosthesis comprises a main tubular body having a proximal end and a distal end and a tubular side arm extending from the main tubular body and wherein the distal end of the tubular prosthesis is adjacent to the proximal end of the pusher catheter;
wherein the pusher extension is external to the tubular prosthesis and extends along an external surface of the tubular prosthesis;
an extension dilator having a first end and a second end and a lumen extending between the first and second ends, wherein the extension dilator extends proximally from the proximal end of the pusher catheter, extends at least partially along the external surface of the main tubular body, into a distal end of the tubular side arm and exits a proximal end of the tubular prosthesis, and
a delivery sheath having a proximal end, a distal end and a lumen extending there between, wherein the sheath has a first position in which the proximal end of the sheath frictionally engages the extension dilator at a location proximal to a proximal end of the prosthesis, and a second position in which the sheath is retracted to a position distal to the proximal end of the prosthesis.

2. The delivery device of claim 1 wherein the sheath retains the prosthesis in a radially-inwardly compressed delivery configuration when the sheath is in the first position.

3. The delivery device of claim 1 wherein a distal end of the tubular prosthesis is releasably coupled to the pusher extension.

4. The delivery device of claim 1 wherein a proximal end and a distal end of the tubular prosthesis are releasably coupled to the pusher extension.

5. The delivery device of claim 1 wherein the tubular prosthesis is releasably coupled to the pusher extension by at least one trigger wire.

6. The delivery device of claim 5 wherein the at least one trigger wire extends through at least a portion of the pusher catheter lumen and weaves through at least one aperture formed in the pusher extension and through at least one of a proximal end and a distal end of the prosthesis.

7. The delivery device of claim 1 wherein the prosthesis has a fenestration formed in a side wall of the main tubular body and wherein a proximal end of the tubular side arm extends from the fenestration.

8. The delivery device of claim 1 wherein the pusher extension is external to the tubular prosthesis and extends along at least a portion of the external surface of only one side of the tubular prosthesis.

9. The delivery device of claim 1 wherein the extension dilator has a first outer diameter at the first end and a second outer diameter at the second end, and wherein the second outer diameter is larger than the first outer diameter.

10. The delivery device of claim 9 wherein the first outer diameter is in a range of about 1 Fr to about 5 Fr and wherein the second outer diameter is in a range of about 8 Fr to about 14 Fr.

11. The delivery device of claim 1 wherein the extension dilator has a radially outwardly flared portion between the first and second ends.

12. The delivery device of claim 1 wherein the proximal end of the sheath tapers radially inwardly and wherein the proximal tapered end of the sheath frictionally engages the extension dilator.

13. The delivery device of claim 1 wherein a proximal segment of the extension dilator has a larger outer diameter than a distal segment of the extension dilator, and wherein the larger outer diameter segment extends proximally from the proximal end of the sheath in a delivery configuration.

14. The delivery device of claim 12 wherein the tapered proximal end of the sheath frictionally engages the extension dilator by friction fit.

15. The delivery device of claim 1 wherein the device is configured for tracking over a guide wire, the guide wire extending through the lumen of the extension dilator and through the lumen of the pusher catheter during delivery.

16. The delivery device of claim 1 wherein the pusher extension comprises at least one of a rod, a post, a wall and a support having a C-shaped cross section that corresponds to the shape of the external surface of at least a portion of the tubular prosthesis.

17. The delivery device of claim 1 wherein the pusher extension extends proximally from the proximal end of the pusher catheter to a location adjacent a proximal end of the prosthesis.

18. The delivery device of claim 1 wherein the pusher extension extends proximally from the proximal end of the pusher catheter to a location adjacent a distal end of the prosthesis.

19. A method for treating a diseased vessel comprising;
providing a prosthesis delivery device comprising a pusher catheter having a proximal end; a pusher extension extending proximally from the proximal end of the pusher catheter; a tubular prosthesis releasably coupled to the pusher extension, wherein the tubular prosthesis comprises a main tubular body having a proximal end and a distal end and a tubular side arm extending from the main tubular body and wherein the distal end of the tubular prosthesis is adjacent to the proximal end of the pusher catheter; wherein the pusher extension is external to the tubular prosthesis and extends along an external surface of the tubular prosthesis; an extension dilator having a lumen, the extension dilator extending proximally from the proximal end of the pusher catheter, extending at least partially along an external surface of the main tubular body, into a distal end of the tubular side arm and exiting a proximal end of the tubular prosthesis; a delivery sheath having a first position in which a proximal end of the sheath frictionally engages the extension dilator at a location proximal to the proximal end of the prosthesis and a second distally retracted position,
tracking the delivery device over a guide wire within a patient's vasculature to position the prosthesis in a main vessel with the tubular side arm adjacent an opening to a branch vessel, wherein the guide wire extends through the lumen of the extension dilator;
retracting the sheath to move it from the first position to the second position to expose at least the proximal end of the stent graft and the tubular side arm;
withdrawing the extension dilator from the vasculature through the proximal end of the prosthesis leaving the guide wire in place to facilitate cannulation of a branch vessel,
tracking an auxiliary sheath over the guide wire into the proximal end of the prosthesis and through the lumen of the tubular side arm until a proximal end of the auxiliary sheath is located adjacent the opening of the branch vessel to facilitate cannulation of the branch vessel;
delivering an extension prosthesis through the auxiliary sheath into the branch vessel, and
deploying the tubular prosthesis and the extension prosthesis and removing the delivery device from the patient's vasculature.

Assignees

• Cook Medical Technologies Llc

Inventors

• Ondersma Joel
• Roeder Blayne A
• Macatangay Edwin E
• Vad Siddharth
• Skender Davorin K

Classifications

• A61F2002/9505

  having retaining means other than an outer sleeve, e.g. male-female connector between stent and instrument · CPC title

• A61F2/856

  Single tubular stent with a side portal passage · CPC title

• A61F2/95

  Instruments specially adapted for placement or removal of stents or stent-grafts · CPC title

• A61F2/954

  for placing stents or stent-grafts in a bifurcation · CPC title

• A61F2/844

  folded prior to deployment · CPC title