Ureteral stent guidewire system

A kit for bypassing obstructions in the ureter with a ureteral stent, said kit comprising:

• (a) a ureteral stent comprising an elongated, relatively flexible, tubular member having at least one drainage opening extending through a wall thereof, said member having a lumen, an open proximal end of reduced diameter and at least one end set in the form of a hook;
• (b) a tubular pusher wire, said pusher wire being sized to fit and move within the lumen of said stent and having a central lumen, the leading end of said pusher wire being larger than the reduced open proximal end of the stent;
• (c) a guidewire, said guidewire being sized to both fit within and move freely in the lumen of said pusher wire so that when the pusher wire and guidewire are within the lumen of the stent they can be advanced to straighten both hooks;
• said guidewire having a leading end which is smaller in diameter than the reduced open proximal end of the stent so that if an obstruction in the ureter is encountered the leading end of the guidewire can be moved out of the pusher wire and the reduced opening of the stent and maneuvered past the obstruction so that both the stent and pusher can be advanced past the obstruction by moving them over the guidewire;
• and
• (d) retaining means for keeping the leading end of the guidewire inside the lumen of the pusher wire until an obstruction is encountered.

A method for inserting a ureteral stent in the ureter and for maneuvering the stent past any obstructions in the ureter which might be encountered, said method comprising:

• (a) introducing into the ureter a ureteral stent comprising an elongated, flexible, tubular member having a lumen, said member having at least one drainage passage extending through a wall thereof connecting the lumen to the outside and a proximal end with a reduced opening;
• said stent having in the lumen thereof a dual wire guidewire system comprising a tubular, flexible pushed wire having a lumen open at both ends;
• a guidewire which is sized to fit within and move in the lumen of the pusher wire;
• and retaining means for retaining the leading end of the guidewire within the lumen of the pusher wire;
• (b) advancing said stent and guidewire system in the patient until an obstruction in the ureter is encountered;
• (c) then disengaging the retaining means and passing the leading end of said guidewire out through the reduced opening and maneuvering the leading end of the guidewire past the obstruction;
• and
• (d) then advancing the pusher wire and the stent over the guidewire and past the obstruction.