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US 2014/0194970 A1Published application
Gate wire for contralateral leg access
AssigneeTriVascular, Inc.
InventorMichael V. Chobotov
Life of this patent
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Abstract
An endovascular delivery system includes a pre-loaded, small guide wire for snaring via the contralateral side of a bifurcated prosthesis for deployment of a graft extension to the contralateral side of the bifurcated prosthesis. The pre-loaded guidewire avoids a cannulation step in the deployment of typical bifurcated stent grafts. Deployment methods using the pre-loaded guidewire and endovascular grafts having a pre-routed lumen for a secondary contralateral access guidewire are also described.
Claims25
An endovascular delivery system, comprising:
- a bifurcated and inflatable prosthesis comprising a main tubular body having an open end and opposed ipsilateral and contralateral legs defining a graft wall therein between, said graft wall having an inner graft wall surface and an outer graft wall surface, and said ipsilateral and contralateral legs having open ends;
- an elongate outer tubular sheath having an open lumen and opposed proximal and distal ends with a medial portion therein between, the proximal end of the outer tubular sheath securably disposed to a first handle at a handle assembly;
- an elongate inner tubular member having a tubular wall with an open lumen and opposed proximal and distal ends with a proximal portion near the proximal end, a distal portion near the distal end and a medial portion therein between, the inner tubular member having a longitudinal length greater than a longitudinal length of the outer tubular sheath, the inner tubular member being slidably disposed within the open lumen of the outer tubular sheath, the proximal end of the inner tubular member securably disposed to a second handle at the handle assembly;
- wherein the distal end of the outer tubular sheath being slidably disposed past and beyond the distal end of the inner tubular member to define a prosthesis delivery state and slidably retractable to the medial portion of the inner tubular member to define a prosthesis unsheathed state;
- a first elongate guidewire slidably disposed within the inner tubular member and extending from the handle assembly, through the ipsilateral leg of the prosthesis and through the main tubular body of the prosthesis in the prosthesis delivery state;
- a second elongate guidewire slidably disposed within the inner tubular member and having a proximal portion extending from the handle assembly or from a proximal portion of the inner tubular member, a medial portion extending through the ipsilateral leg of the prosthesis and a distal portion extending through at least a portion of the contralateral leg of the main tubular body of the prosthesis in the prosthesis delivery state;
- whereby the distal portion of the second elongate guidewire is engageable with a catheter to facilitate delivery of a contralateral graft extension within a portion of the contralateral leg of the main tubular body of the prosthesis in the prosthesis unsheathed state upon proximally retracting the second elongate guidewire.
4 more elements
A method for delivering a bifurcated prosthesis, comprising:
- providing the endovascular delivery system comprising:
- a bifurcated and inflatable prosthesis comprising a main tubular body having an open end and opposed ipsilateral and contralateral legs defining a graft wall therein between;
- an elongate outer tubular sheath having an open lumen and opposed proximal and distal ends with a medial portion therein between;
- an elongate inner tubular member having a tubular wall with an open lumen and opposed proximal and distal ends with a proximal portion near the proximal end, a distal portion near the distal end and a medial portion therein between, the inner tubular member having a longitudinal length greater than a longitudinal length of the outer tubular sheath, the inner tubular member being slidably disposed within the open lumen of the outer tubular sheath, wherein the distal end of the outer tubular sheath being slidably disposed past and beyond the distal end of the inner tubular member to define a prosthesis delivery state and slidably retractable to the medial portion of the inner tubular member to define a prosthesis unsheathed state;
- a first elongate guidewire slidably disposed within the inner tubular member and extending through the ipsilateral leg of the prosthesis and through the main tubular body of the prosthesis in the prosthesis delivery state;
- a second elongate guidewire slidably disposed within the inner tubular member and extending through the ipsilateral leg of the prosthesis and having a distal portion extending through at least a portion of the contralateral leg of the main tubular body of the prosthesis in the prosthesis delivery state;
- advancing the endovascular delivery system through a first branched artery and into an aneurysm in a main artery;
- retracting the outer sheath to deploy the prosthesis so the proximal end of the main tubular body of the prosthesis is disposed beyond the aneurysm and so that the ipsilateral and contralateral legs are disposed within the aneurysm;
- advancing a catheter through a second branched artery;
- engaging the catheter with the distal portion of the second elongate guidewire;
- retracting the second elongate guidewire proximally to advance the catheter within a portion of the contralateral leg of the prosthesis;
- disengaging the second elongate guidewire and the catheter from one and the other;
- and
- further retracting the second elongate guidewire at least partially through the ipsilateral leg of the prosthesis.
11 more elements
An endovascular prosthesis, comprising:
- a bifurcated and inflatable prosthesis comprising:
- a main tubular body having an open end and opposed ipsilateral and contralateral legs defining a graft wall therein between, said graft wall having an inner graft wall surface and an outer graft wall surface, and said ipsilateral and contralateral legs having open ends;
- and
- a prosthesis guidewire lumen extending along at least a portion of the inner graft wall surface of the ipsilateral leg of the prosthesis and extending along at least a portion of the inner graft wall surface of the contralateral leg of the prosthesis;
- wherein the prosthesis guidewire lumen is configured to receive a guidewire from a delivery system.
2 more elements
Dependencies are inferred from the claim text.