Devices, systems, and methods for endovascular staple and/or prosthesis delivery and implantation
Devices, systems, and methods for implanting expandable prostheses in the body lumens rely on stapling or anchoring the prostheses with separately introduced fasteners. The prostheses may be self-expanding or balloon expandable, and may include a single lumen or more than one lumen. After initial placement, a stapling system is introduced within the expanded prosthesis to deploy a plurality of fasteners to at least one prosthesis end. The stapling system may apply a force to the prosthesis to modify the shape of the prosthesis to conform to the shape of the vessel wall. The stapling system can be deflected in one or more distinct steerable segments. A lumen extension or lumens may be coupled to the prosthesis to extend the reach of the prosthesis within the implantation site. Fasteners may also be applied to the lumen extensions.
1 . A prosthesis delivery catheter comprising:
a delivery catheter comprising a flexible inner assembly and an outer prosthesis retention jacket, the outer prosthesis retention jacket being sized and configured to slide over at least a portion of the inner assembly from a first position to a second position, and
a control handle coupled to a proximal end of the delivery catheter, the control handle including a retention jacket control mechanism adapted to provide a mechanical advantage to slide the retention jacket over at least a portion of the inner assembly.
2 . A catheter according to claim 1 :
wherein the retention jacket control mechanism is adapted to provide the mechanical advantage to slide the retention jacket over at least a portion of the inner assembly from the first position to the second position.
3 . A catheter according to claim 2 :
wherein the mechanical advantage is adapted to be disengaged at any point along the travel from the first position to the second position.
4 . A catheter according to claim 3 :
wherein the mechanical advantage is adapted to be reengaged at any point along the travel from the first position to the second position.
5 . A catheter according to claim 3 :
wherein when the mechanical advantage is disengaged, the retention jacket control mechanism is adapted to provide a non-mechanical advantage force to slide the retention jacket over at least a portion of the inner assembly.
6 . A catheter according to claim 1 :
wherein the retention jacket control mechanism comprises a rack and pinion mechanism.
7 . A catheter according to claim 1 :
wherein the retention jacket control mechanism comprises a reel and cable mechanism.
8 . A catheter according to claim 1 :
wherein the retention jacket control mechanism comprises an exterior threaded rod with an internal threaded component.
9 . A catheter according to claim 1 :
wherein the outer prosthesis retention jacket is sized and configured to slide over a preloaded prosthesis from the first position to the second position spaced away from the preloaded prosthesis.
10 . A catheter according to claim 1 :
wherein the retention jacket control mechanism is coupled to a first control and a second control, the first control and second control adapted to affect retraction of the prosthesis retention jacket in a stepwise fashion.
11 . A method comprising:
providing a delivery catheter comprising:
a flexible inner assembly and an outer prosthesis retention jacket, the outer prosthesis retention jacket being sized and configured to slide over at least a portion of the inner assembly from a first position to a second position, and
a control handle coupled to a proximal end of the delivery catheter, the control handle including a retention jacket control mechanism adapted to provide a mechanical advantage to slide the retention jacket over at least a portion of the inner assembly,
introducing into a vessel the delivery catheter,
advancing the delivery catheter to the targeted site in the vessel,
manipulating the retention jacket control mechanism, and
providing a mechanical advantage for sliding the retention jacket over at least a portion of the inner assembly.
12 . A method according to claim 11 :
further including disengaging the mechanical advantage at any point along the travel from the first position to the second position.
13 . A method according to claim 12 :
further including reengaging the mechanical advantage at any point along the travel from the first position to the second position.
14 . A method according to claim 12 :
wherein when the mechanical advantage is disengaged, the retention jacket control mechanism is adapted to provide a non-mechanical advantage force to slide the retention jacket over at least a portion of the inner assembly.
15 . A method according to claim 11 :
wherein the retention jacket control mechanism is adapted to provide the mechanical advantage to slide the retention jacket over at least a portion of the inner assembly from the first position to the second position.
16 . A system comprising:
a delivery catheter comprising a flexible inner assembly and an outer prosthesis retention jacket, the outer prosthesis retention jacket being sized and configured to slide over at least a portion of the inner assembly from a first position to a second position,
a control handle coupled to a proximal end of the delivery catheter, the control handle including a retention jacket control mechanism adapted to provide a mechanical advantage to slide the retention jacket over at least a portion of the inner assembly, and
instructions for use describing the use of the system, the instructions comprising the operations of introducing into a vessel the delivery catheter, advancing the delivery catheter to the targeted site in the vessel, manipulating the retention jacket control mechanism, and providing a mechanical advantage for sliding the retention jacket over at least a portion of the inner assembly.