Noncylindrical drug eluting stent for treating vascular bifurcations
View Patent ↗A device and method for treating pathological narrowing of fluid-carrying conduits of the human body (such as blood vessels) in an area of a bifurcation is disclosed. In particular, a stent delivery system configured to carry one or more of a pair of dissimilar stents. At least one of the stents is particularly suited for treating a widened portion of a blood vessel immediately proximal to a bifurcation. The stent delivery system can also include a handpiece adapted to selectively deliver the stents.
1. A method of treating a vascular bifurcation of a main coronary vessel into a first and a second branch vessels, comprising the steps of:
providing a delivery catheter having a stent thereon, the stent having an upstream end and a downstream end with at least one marker on the downstream end, and being self expandable to a configuration having a single central lumen in which the upstream end has a smaller dimension than the downstream end;
positioning the catheter such that the stent is at a treatment site within the main coronary vessel with the downstream end adjacent the vascular bifurcation;
deploying the stent in the main coronary vessel such that the stent self expands to a configuration in which the upstream end of the stent has a smaller dimension than the downstream end of the stent, and in which the downstream end communicates with both the first and the second branch vessels, wherein said deploying comprises moving a releasable restraint having a plurality of expansion limiting bands with respect to said stent; and
eluting a drug from the stent at the treatment site.
2. A method of treating a vascular bifurcation of a main vessel into a first and a second branch vessels as in claim 1 , wherein the eluting a drug step comprises eluting a smooth muscle cell proliferation inhibitor.
3. A method of treating a vascular bifurcation of a main vessel into a first and a second branch vessels as in claim 2 , wherein the smooth muscle cell proliferation inhibitor comprises rapamycin.
4. A method of treating a vascular bifurcation of a main vessel into a first and a second branch vessels as in claim 1 , wherein the eluting a drug step comprises eluting angiopeptin.
5. A method of treating a vascular bifurcation of a main vessel into a first and a second branch vessels as in claim 1 , wherein the eluting a drug step comprises eluting a platelet aggregation inhibitor.
6. A method of treating a vascular bifurcation of a main vessel into a first and a second branch vessels as in claim 1 , wherein the eluting a drug step comprises eluting an anti-inflammatory agent.
7. A method of treating a vascular bifurcation of a main vessel into a first and a second branch vessels as in claim 1 , wherein the eluting a drug step comprises eluting an antibiotic agent.
8. A method of treating a vascular bifurcation of a main vessel into a first and a second branch vessels as in claim 1 , wherein the eluting a drug step comprises eluting paclitaxel.
9. A method of treating a vascular bifurcation of a main vessel into a first and a second branch vessels as in claim 1 , further comprising the step of deploying a second stent in one of the first and second brunch vessels.
10. A method of treating a vascular bifurcation of a main vessel into a first and a second branch vessels as in claim 1 , wherein the distal end of the first stent expands to a dimension that is at least about 105% of the dimension of the proximal end of the first stent.
11. A method of treating a vascular bifurcation of a main vessel into a first and a second branch vessels as in claim 1 , wherein the at least one marker extends at least partially beyond the downstream end.
12. A method of treating a vascular bifurcation of a main vessel into a first and a second branch vessels as in claim 1 , wherein the at least one marker is pressed into the stent.
13. A method of treating a vascular bifurcation of a main vessel into a first and a second branch vessels as in claim 1 , wherein the expansion limiting bands comprise stainless steel.
14. A method of treating a vascular bifurcation of a main vessel into a first and a second branch vessels as in claim 1 , wherein the expansion limiting bands comprise braided tube.
15. A method of treating a vascular bifurcation of a main coronary vessel into first and second branch vessels, comprising the steps of:
deploying a substantially cylindrical stent in a first branch vessel which is downstream with respect to the bifurcation;
deploying a tapered stent in the main coronary vessel, upstream with respect to the bifurcation, such that the tapered stent has at least one marker and a single central lumen and tapers in the downstream direction from a smaller upstream end to a larger downstream end which faces the bifurcation, wherein said deploying a tapered stent comprises moving a releasable restraint having a plurality of expansion limiting bands with respect to said tapered stent; and
delivering an active agent from at least one of the cylindrical and the tapered stents.
16. A method of treating a vascular bifurcation as in claim 15 , wherein the active agent comprises paclitaxel.
17. A method of treating a vascular bifurcation as in claim 15 , wherein the active agent comprises rapamycin.
18. A method of treating a vascular bifurcation as in claim 15 , wherein the active agent comprises a smooth muscle cell proliferation inhibitor.
19. A method of treating a vascular bifurcation as in claim 15 , wherein the active agent comprises a platelet aggregation inhibitor.
20. A method of treating a vascular bifurcation as in claim 15 , wherein the active agent comprises an anti-inflammatory agent.
21. A method of treating a vascular bifurcation as in claim 15 , wherein the active agent comprises an antibiotic agent.
22. A method of treating a vascular bifurcation as in claim 15 , wherein the active agent comprises a calcium entry blocker.
23. A method of treating a vascular bifurcation as in claim 15 , wherein the active agent comprises an antimicrobial agent.
24. A method of treating a vascular bifurcation as in claim 15 , wherein the at least one marker extends at least partially beyond the downstream end.
25. A method of treating a vascular bifurcation as in claim 15 , wherein the at least one marker is pressed into the tapered stent.
26. A method of treating a vascular bifurcation as in claim 15 , wherein the expansion limiting bands comprise stainless steel.
27. A method of treating a vascular bifurcation as in claim 15 , wherein the expansion limiting bands comprise braided tube.