Delivery device with an extension sheath and methods of using the same
View Patent ↗Methods for delivering and deploying an endovascular graft to the common and internal iliac arteries are described. A system including a pre-loaded delivery device with a releasably attached extension cannula and an extension sheath for use with such methods is also described.
1. A prosthesis delivery device comprising:
an inner cannula having a proximal end;
a nose cone dilator extending proximally from the proximal end of the inner cannula, the nose cone dilator having a proximal end and a distal end and a groove extending longitudinally along at least a portion of an outer surface of the nose cone dilator between the proximal and distal ends;
an extension cannula having a proximal end and a distal end releasably attached to the proximal end of the nose cone dilator;
an extension sheath coaxial with at least a portion of the extension cannula, wherein the extension sheath has a proximal end and a distal end and a lumen extending between the proximal and distal ends, and wherein the distal end of the extension sheath flares radially outwardly at an angle;
a main sheath having a proximal end, a distal end and a lumen extending therebetween, wherein the main sheath has a first position in which the proximal end of the main sheath is at least partially overlapping and coaxial with the distal end of the extension sheath and wherein the proximal end of the main sheath tapers radially inwardly at an angle and wherein the angle of the taper of the proximal end of the main sheath substantially corresponds with the angle of the radially outwardly flared distal end of the extension sheath, and a second position in which the proximal end of the main sheath is distal to the distal end of the extension sheath; and
a pre-loaded guide wire extending proximally at least partially through the lumen of the main sheath, through the groove formed in the nose cone dilator and proximally at least partially through the lumen of the extension sheath.
2. The device of claim 1 wherein the proximal end of the nose cone dilator has an outer diameter and wherein the radially outwardly flared distal end of the extension sheath has an outer diameter that is substantially equal to the outer diameter of the proximal end of the nose cone dilator.
3. The device of claim 1 wherein the distal end of the extension cannula extends distally beyond the distal end of the extension sheath.
4. The device of claim 1 wherein the nose cone dilator further comprises a lumen extending between the proximal and distal ends of the nose cone dilator and wherein the distal end of the extension cannula extends at least partially into the lumen at the proximal end of the nose cone dilator when the extension cannula is releasably attached to the nose cone dilator.
5. The device of claim 1 wherein the proximal end of the main sheath deforms radially outwardly when the proximal end of the main sheath is coaxial with the distal end of the extension sheath.
6. The device of claim 1 wherein movement of the main sheath from the first position to the second position requires between about 20 Newtons to about 80 Newtons of force.
7. The device of claim 1 further comprising an extension nose cone dilator extending proximally from the proximal end of the extension sheath.
8. The device of claim 1 wherein the extension cannula is attached to the nose cone dilator when the main sheath is in the first position and wherein the extension cannula is separable from the nose cone dilator when the main sheath is in the second position.
9. The device of claim 1 wherein the distal end of the extension sheath abuts the proximal end of the nose cone dilator when the extension cannula is attached to the nose cone dilator.
10. The device of claim 1 wherein at least a portion of the proximal end of the nose cone dilator is received within the lumen of the distal end of the extension sheath when the extension cannula is attached to the nose cone dilator.
11. The device of claim 1 wherein the distal end of the extension sheath is retained between an inner surface of the main sheath and the outer surface of the nose cone dilator when the main sheath is in the first position.
12. The device of claim 1 further comprising a stent graft releasably coupled to the inner cannula at a location distal to the nose cone dilator and wherein the stent graft is held in a radially inwardly contracted condition by the main sheath when the main sheath is in the first position.