摘要:
Stent delivery devices include at least one implantable stent carrier and/or membrane for carrying multiple stents or stent segments over an expandable member. At least a portion of the implantable carrier is expandable by the expandable member to deploy the portion of the carrier and one or more stent segments disposed thereon. A sheath may be retracted to expose and expand a distal portion of the expandable member to expand and deploy a distal portion of the carrier and the stent segment(s) disposed thereon. Stent delivery devices and methods provide enhanced delivery of multiple stents or stent segments by delivering the segments while coupled with one or more implantable carriers and/or membranes that are typically flexible and dividable.
摘要:
A suture applying device comprises a shaft having a nose piece attached at its distal end. The shaft and the nose piece are separated by a transition region, and a needle entry lumen in the shaft permits a flexible needle to be introduced in the distal direction. The needle is able to cross the transition region and penetrate tissue held therein and enter into a return lumen in the nose piece. The return lumen is U-shaped and acts to bend the flexible needle as it is advanced. In this way, the needle passes from the nose piece through the transition region in a proximal direction, and is able to pass through tissue within the transition region generally on the opposite side of a tissue puncture from the first suture passage. The needle then exits from the device, permitting the suture attached to the needle to be drawn fully through the device. The suture may then be tied in order to close and seal the tissue penetration.
摘要:
An overtube apparatus for insertion into a body is described herein. The assembly includes an overtube having a lumen defined throughout. The distal end of the overtube member has two or more windows in apposition configured to draw in tissue via a vacuum. A drive tube, which also defines a lumen, is inserted and is freely adjustable within the overtube. A spiral or helical fastener, which is temporarily attached to the drive tube distal end, is positioned within the overtube lumen. Endoscopic devices can be inserted within the drive tube lumen and advanced past the distal ends of both the drive tube and overtube. A pump provides the vacuum to draw apposed regions of tissue from within a hollow body organ into the windows of the overtube. Once the tissue has been invaginated, the drive tube is rotated to advance the fastener into the tissue to fasten them together.
摘要:
Stent delivery devices and methods include multiple stents or stent segments mounted at fixed positions on an expandable member of the stent delivery catheter. One or more of the fixed-position stents may be selectively deployed in a body lumen such as a blood vessel by positioning one or more sheaths to constrain some stents while exposing other for deployment. Some embodiments include two axially movable sheaths for serially deploying stents while containing a portion of the expandable balloon from which stents have been deployed. Other embodiments include inner and outer balloon shafts to allow the balloon to be retracted into the delivery catheter as stents are deployed. Devices and methods of the invention provide enhanced serial deployment of multiple stents or stent segments while reducing the risk of damage to an expandable deployment member.
摘要:
Apparatus and methods for stent delivery provide for dilatation at a treatment site as well as stent delivery, using the same stent delivery apparatus. Apparatus generally include a catheter having at least one expandable member, at least one stent positionable thereon, and a sheath disposed over the expandable member and the stent. Some embodiments include separate expandable members for dilatation of a lesion and for stent expansion, while other embodiments use the same expandable member for both. In some embodiments a stent includes multiple separable stent segments. In various embodiments, self-expanding stents may be used. Methods involve positioning a stent delivery device at a treatment site, expanding an expandable member to dilate at least a portion of a lesion at the treatment site, and expanding (or allowing to expand) a stent at the treatment site.
摘要:
Apparatus for delivering stents to body lumens include one or more tubular prostheses carried at the distal end of a catheter shaft, a sheath slidably disposed over the prostheses, and a guidewire tube extending from within the sheath to the exterior of the sheath through an exit port in a sidewall thereof. A guidewire extends slidably through the guidewire tube. The sheath can be moved relative to the catheter shaft and the guidewire tube to expose the prostheses for deployment. Methods of delivering stents are also provided.
摘要:
Stent delivery devices include at least one implantable stent carrier and/or membrane for carrying multiple stents or stent segments over an expandable member. At least a portion of the implantable carrier is expandable by the expandable member to deploy the portion of the carrier and one or more stent segments disposed thereon. A sheath may be retracted to expose and expand a distal portion of the expandable member to expand and deploy a distal portion of the carrier and the stent segment(s) disposed thereon. Stent delivery devices and methods provide enhanced delivery of multiple stents or stent segments by delivering the segments while coupled with one or more implantable carriers and/or membranes that are typically flexible and dividable.
摘要:
Blood vessels and other body lumens are expanded using an evertible braided prosthesis. The braided prosthesis is delivered to the blood vessel in a radially collapsed configuration. A leading edge of the braided prosthesis is then everted so that it expands as it is advanced through the blood vessel. Optionally, the prosthesis can be provided with a biologically active substance in order to inhibit hyperplasia or have other desired biological effects.
摘要:
Methods and devices provide delivery of one or more therapeutic agents to a treatment site at or near an aneurysm, such as an abdominal aortic aneurysm (“AAA”). Methods typically include placing a device at or near the AAA and releasing one or more therapeutic agents from the device. This may also involve releasing multiple agents in sequential fashion. Examples of possible therapeutic agents include doxycycline, roxithromycin, tetracycline, tetracycline derivatives, and collagen promoting agents, such as propranolol. Devices used to deliver one or more therapeutic agents may include stents, grafts, stent grafts, balloons with perforations and/or needles, expandable wire baskets, drug-eluting capsules, or suitable combinations thereof. One embodiment includes a stent graft with a distally-extending skirt and an supra-renal anchor.
摘要:
Custom-length self-expanding stent delivery systems and methods enable precise control of prosthesis position during deployment. The stent delivery systems carry multiple stent segments and include a stent bumper for helping control the axial position of the stent segments during deployment. This enables the deployment of multiple prostheses at a target site with precision and predictability, preventing stent segment recoil and ejection from the delivery device and thus eliminating excessive spacing or overlap between prostheses. In particular embodiments, the prostheses of the invention are deployed in stenotic lesions in coronary or peripheral arteries or in other vascular locations.