Introducer with side opening

Patent metadata

Field	Value
Publication number	US-2016175128-A1
Application number	US-201514978666-A
Country	US
Kind code	A1
Filing date	Dec 22, 2015
Priority date	Dec 23, 2014
Publication date	Jun 23, 2016
Grant date	—

Abstract

An introducer for an endoluminal prosthesis and a methods for delivering a prosthesis within a body vessel are described. The introducer comprises pusher catheter having a lumen extending therethrough, the lumen being in communication with an opening formed in the sidewall of the pusher. A sheath is disposed over the pusher catheter and also has an opening formed in its sidewall. The sheath is longitudinally movable relative to the pusher catheter between a prosthesis delivery position and a prosthesis deployment position. When the sheath is in the deployment position, the opening formed in the sidewall of the pusher catheter is at least partially longitudinally aligned with the opening formed in the sidewall of the sheath. A wire may extend though the opening in the sheath, the opening in the pusher, through the lumen of the pusher and through a fenestration in a prosthesis to cannulate a branch vessel.

First claim

We claim:

1 . An introducer for an endoluminal prosthesis comprising:
an inner cannula having a proximal end and a distal end and a prosthesis releasably attached to the proximal end of the inner cannula; a pusher catheter disposed about at least a portion of the inner cannula, the pusher catheter having a proximal end a distal end and a side wall extending between the proximal and distal ends, the side wall comprising an opening formed therein, a lumen extending at least partially through the pusher catheter between the proximal and distal ends of the pusher catheter, the pusher catheter lumen being in communication with the opening formed in the side wall of the pusher catheter; and a tubular sheath disposed coaxially about at least a portion of the pusher catheter, the tubular sheath having a proximal end, a distal end, a sidewall extending between the proximal and distal ends of the sheath and an opening formed in the sheath sidewall; wherein the sheath is longitudinally movable relative to the pusher catheter between a prosthesis delivery position and a prosthesis deployment position.

2 . The introducer of claim 1 , wherein when the sheath is in the prosthesis deployment position, the opening formed in the sidewall of the pusher catheter is at least partially longitudinally aligned with the opening formed in the sidewall of the sheath.

3 . The introducer of claim 1 , wherein when the sheath is in the delivery position, the opening formed in the sidewall of the sheath is not longitudinally aligned with the opening formed in the sidewall of the sheath.

4 . The introducer of claim 1 , wherein the opening formed in the sidewall of the sheath comprises a slot extending longitudinally along at least a portion of the sheath such that the slot formed in the sheath and the opening formed in the sidewall of the pusher catheter are longitudinally aligned when the sheath is in both the delivery position and in the deployment position.

5 . The introducer of claim 1 , wherein the pusher catheter further comprises a port that extends radially outwardly from the sidewall of the pusher catheter and wherein the port is in fluid communication with the opening formed in the side wall of the pusher catheter.

6 . The introducer of claim 1 wherein the pusher catheter further comprises a second opening formed in the sidewall of the pusher catheter.

7 . The introducer of claim 6 wherein the pusher catheter further comprises a second lumen extending at least partially through the pusher catheter between the proximal and distal ends of the pusher catheter, the second pusher catheter lumen being in communication with the second opening formed in the side wall of the pusher catheter.

8 . The introducer of claim 7 wherein the second pusher catheter lumen extends from the proximal end of the pusher catheter to the second opening formed in the sidewall of the pusher catheter.

9 . The introducer of claim 7 wherein the tubular sheath comprises a second opening formed in the sidewall of the sheath.

10 . The introducer of claim 9 wherein when the sheath is in the deployment position, the second opening formed in the sidewall of the sheath is at least partially longitudinally aligned with the second opening formed in the sidewall of the pusher catheter.

11 . The introducer of claim 1 , further comprising at least one annular sealing member disposed between the pusher catheter and the sheath to fluidly isolate the pusher catheter lumen from the opening formed in the sidewall of the sheath when the sheath is in the delivery position.

12 . The introducer of claim 1 , further comprising a seal disposed within the opening formed in the sidewall of the sheath.

13 . The introducer of claim 1 , wherein the pusher catheter further comprises a groove formed along at least a portion of pusher catheter sidewall, the groove extending longitudinally from the opening formed in the sidewall of the pusher catheter in a distal direction.

14 . The introducer of claim 13 , wherein when the sheath is in the deployment position, the opening formed in the sidewall of the sheath is at least partially longitudinally aligned with the groove.

15 . The introducer of claim 1 , wherein a wire is disposed longitudinally within at least a portion the pusher catheter lumen.

16 . The introducer of claim 15 further comprising a suture releasably engaged with a portion of the wire extending through the pusher catheter lumen, wherein the suture is disposed about the wire at a location adjacent to the opening formed in the sidewall of the pusher catheter.

17 . The introducer of claim 15 wherein the prosthesis further comprises at least one fenestration formed therein and wherein when the sheath is in the deployment position, the wire extends through the opening formed in the side wall of the sheath and through the opening formed in the sidewall of the pusher catheter, further extends proximally through the pusher catheter lumen and through the fenestration formed in the prosthesis.

18 . A method for delivering an endoluminal prosthesis using an introducer, the method comprising:
providing an introducer comprising an inner cannula having a proximal end and a distal end and a prosthesis releasably attached to the proximal end of the inner cannula, a pusher catheter disposed about at least a portion of the inner cannula, the pusher catheter having a proximal end a distal end and a side wall extending between the proximal and distal ends, the side wall comprising an opening formed therein, a lumen extending at least partially through the pusher catheter between the proximal and distal ends of the pusher catheter, the pusher catheter lumen being in communication with the opening formed in the side wall of the pusher catheter, and a tubular sheath disposed coaxially about at least a portion of the pusher catheter, the tubular sheath having a proximal end, a distal end, a sidewall extending between the proximal and distal ends of the sheath and an opening formed in the sheath sidewall, moving the sheath relative to the pusher catheter from a prosthesis delivery position to a prosthesis deployment position such that when the sheath is in the prosthesis deployment position, the opening formed in the sidewall of the sheath is at least partially aligned with the opening formed in the sidewall of the pusher catheter.

19 . The method of claim 18 further comprising extending a wire through the opening formed in the sidewall of the sheath, through the opening formed in the sidewall of the pusher catheter and proximally through the pusher catheter lumen and through a fenestration formed in the prosthesis after the prosthesis has been at least partially deployed to cannulate with the wire a branch vessel extending from a main vessel in which the prosthesis is at least partially deployed.

20 . The method of claim 19 further comprising:
removing the introducer from the main vessel after the prosthesis is deployed,
tracking a second prosthesis over the wire and into the cannulated branch vessel, and
deploying the second prosthesis in the branch vessel.

21 . The introducer of claim 1 , wherein the opening in the sheath is covered by a membrane.

22 . The introducer of claim 1 , wherein the sheath has an inner layer and an outer layers and wherein the sheath is configured to receive a wire that extends at least partially longitudinally between the inner layer and the outer layer of the sheath.

Assignees

• Cook Medical Technologies Llc

Inventors

• Diaz Nuno
• Roeder Blayne A
• Vad Siddharth
• Haulon Stephan

Classifications

• A61F2/954

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

• A61F2/95 Primary

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

• A61F2/92

  Stents in the form of a rolled-up sheet expanding after insertion into the vessel {, e.g. with a spiral shape in cross-section} · CPC title

• A61F2/966 Primary

  with relative longitudinal movement between outer sleeve and prosthesis, e.g. using a push rod · CPC title