Catheter system for stenting and drug treatment of bifurcated vessels
A catheter system and method are described for stenting a vessel at a bifurcation or sidebranch of the vessel. The catheter system includes a first balloon catheter, a second balloon catheter and a releasable linking device for holding the first and second balloon catheters arranged in a side-by-side configuration and aligned with one another along a longitudinal axis so that the catheter system can be advanced as a unit. The catheter system is combined with drug eluting technology to prevent restenosis, inflammation and/or thrombosis and/or to promote reendothelialization in the vessel bifurcation. The main vessel stent and/or the sidebranch stent may be coated or impregnated with one or more drugs or bioactive substances. Alternatively or in addition, the first balloon and/or the second balloon may be coated with or include a mechanism for delivering one or more drugs or bioactive substances to the vessel wall.
1. A catheter system comprising:
a first rapid exchange balloon dilatation catheter having a shaft with a proximal end and a distal end, wherein a proximal section of the shaft of the first rapid exchange balloon dilatation catheter is constructed of hypodermic tubing joined to a flexible distal section, and a first inflatable balloon mounted on the flexible distal section of the shaft;
a second rapid exchange balloon dilatation catheter having a shaft with a proximal end and a distal end, wherein a proximal section of the shaft of the second rapid exchange balloon dilatation catheter is constructed of hypodermic tubing joined to a flexible distal section, and a second inflatable balloon mounted on the flexible distal section of the shaft;
an expandable stent mounted on the first inflatable balloon;
and an elongated split-tube linking device having an inner lumen and a longitudinal split through a wall of the split-tube linking device that connects the inner lumen with an exterior of the split-tube linking device and a distal pull-tab located on a side of the split-tube linking device opposite to the longitudinal split, wherein the split-tube linking device has a linked position in which the inner lumen holds the proximal sections of the first rapid exchange balloon dilatation catheter and the second rapid exchange balloon dilatation catheter together with sufficient friction that the catheter system can be advanced as a unit without any relative longitudinal movement between the first rapid exchange balloon dilatation catheter and the second rapid exchange balloon dilatation catheter and a released position in which the first rapid exchange balloon dilatation catheter and the second rapid exchange balloon dilatation catheter are released to allow longitudinal movement of the first rapid exchange balloon dilatation catheter and the second rapid exchange balloon dilatation catheter with respect to each other;
wherein at least one of the stent, the first balloon or the second balloon is configured to deliver a drug or bioactive substance to a vessel wall.
2. The catheter system of claim 1 , wherein the split-tube linking device is configured to be convertible from the linked position to the released position by initiating separation of the split-tube linking device from the proximal sections of the first rapid exchange balloon dilatation catheter and the second rapid exchange balloon dilatation catheter by pulling the distal pull-tab to the side away from the longitudinal split, and by advancing the first rapid exchange balloon dilatation catheter and the second rapid exchange balloon dilatation catheter into a patient, thereby causing the split-tube linking device to demount from the proximal sections of the first rapid exchange balloon dilatation catheter and the second rapid exchange balloon dilatation catheter.
3. The catheter system of claim 1 , wherein the second rapid exchange balloon dilatation catheter has an elongated flexible extension tube extending distally from the second inflatable balloon, and wherein the catheter system has an undeployed position in which the first rapid exchange balloon dilatation catheter and the second rapid exchange balloon dilatation catheter are initially positioned in a tandem configuration with the first inflatable balloon of the first rapid exchange balloon dilatation catheter positioned distally to the second inflatable balloon of the second rapid exchange balloon dilatation catheter, and wherein the elongated flexible extension tube of the second rapid exchange balloon dilatation catheter extends alongside of the first inflatable balloon of the first rapid exchange balloon dilatation catheter, and wherein the expandable stent is mounted over the first inflatable balloon of the first rapid exchange balloon dilatation catheter and at least a portion of the elongated flexible extension tube.
4. The catheter system of claim 1 , wherein the first inflatable balloon is configured to deliver the drug or bioactive substance to the vessel wall.
5. The catheter system of claim 1 , wherein the second inflatable balloon is configured to deliver the drug or bioactive substance to the vessel wall.
6. The catheter system of claim 1 , wherein the first and second inflatable balloons are configured to deliver the drug or bioactive substance to the vessel wall.
7. The catheter system of claim 1 , wherein the stent is configured to deliver the drug or bioactive substance to the vessel wall.
8. The catheter system as in any one of claims 1 , 4 , 5 , 6 or 7 , wherein the drug or bioactive substance comprises paclitaxel.