Medical device introducer assembly particularly for branched medical devices
An introducer assembly includes a distal sheath and a proximal sheath. A splitting element is located at a proximal end of the distal sheath and is arranged to split the distal sheath in a distal direction, so as to deploy first a branch element of a medical device and thereafter the distal end of the medical device. The proximal sheath can then be retracted to release the proximal end of the medical device. Deployment of the medical device from the branch element first enables accurate positioning of the branch element prior to deployment of the main body portion of the medical device.
1. An introducer assembly for deploying a medical device, the assembly including an elongate carrier member having a proximal portion and a distal portion, the distal portion having a distal end and a medical device support zone; a first proximal sheath disposed over the proximal portion of the carrier member and a second distal sheath disposed over the distal portion and over at least a part of the medical device support zone, the second sheath including a second sheath distal end and a second sheath proximal end, and a splitting mechanism cooperatively coupled to the second sheath and arranged to split the second sheath from its second sheath proximal end to its second sheath distal end.
2. The introducer assembly according to claim 1 , including an introducer tip coupled to the distal end of the elongate carrier member, the splitting mechanism including a drive element connected at the introducer tip for pulling the splitting mechanism towards the introducer tip.
3. The introducer assembly according to claim 2 , wherein the drive element is a wire or string.
4. The introducer assembly according to claim 2 , wherein the introducer tip includes a recess for receiving the splitting element.
5. The introducer assembly according to claim 1 , wherein the splitting mechanism includes a cutting element which engages with the second sheath from the second sheath proximal end.
6. The introducer assembly according to claim 5 , wherein the cutting element is in the form of a cutting hook.
7. The introducer assembly according to claim 1 , wherein a distal end of the first proximal sheath is disposed over a proximal end of the second distal sheath prior to deployment.
8. The introducer assembly according to claim 1 , wherein the second distal sheath is separable from the introducer assembly.
9. The introducer assembly according to claim 1 , including a medical device carried on the carrier member, wherein a distal end of the medical device is deployable by splitting the second distal sheath.
10. The introducer assembly according to claim 9 , wherein the medical device includes a branch section, the branch section being held by the first or the second distal sheath prior to deployment.
11. The introducer assembly according to claim 9 , wherein the medical device is a branched stent graft.
12. The introducer assembly according to claim 1 , wherein the first proximal sheath is slidable in a proximal direction relative to the carrier member for deploying a medical device carried in the introducer assembly.
13. A medical apparatus including:
an introducer assembly for deploying a medical device, the assembly including an elongate carrier member having a proximal portion and a distal portion, the distal portion having a distal end and a medical device support zone; a first proximal sheath disposed over the proximal portion of the carrier member and a second distal sheath disposed over the distal portion and over at least a part of the medical device support zone, the second sheath including a second sheath distal end and a second sheath proximal end, and a splitting mechanism cooperatively coupled to the second sheath and arranged to split the second sheath from its second sheath proximal end to its second sheath distal end;
a medical device carried on the elongate carrier member, the medical device including a proximal portion, a distal portion and an intermediate portion therebetween, wherein the medical device proximal portion is covered by the first proximal sheath and the distal portion is covered by the second distal sheath;
wherein the medical device is releasable from the introducer assembly by exposure first of the intermediate portion while at least the medical device proximal portion is held in the first proximal sheath.
14. The apparatus according to claim 13 , wherein the intermediate portion includes a branch member, wherein the branch member is exposed while at least the medical device proximal portion is held in the first proximal sheath.
15. The apparatus according to claim 14 , wherein the branch member is at least partially covered by the second sheath.
16. A method of deploying a medical device in a patient by means of an introducer assembly including an elongate carrier member having a proximal portion and a distal portion, the distal portion having a distal end and a medical device support zone; a first proximal sheath disposed over the proximal portion of the carrier member and a second distal sheath disposed over the distal portion and over at least a part of the medical device support zone, the second sheath including a second sheath distal end and a second sheath proximal end, and a splitting mechanism cooperatively coupled to the second sheath and arranged to split the second sheath from its second sheath proximal end to its second sheath distal end; a medical device being carried on the elongate carrier member, the medical device including a proximal portion, a distal portion and an intermediate portion, wherein the medical device proximal portion is covered by the first proximal sheath and at least the distal portion is covered by the second distal sheath;
wherein the method includes the steps of:
releasing the intermediate portion;
splitting the second distal sheath from the proximal end thereof to expose at least the distal portion of the medical device while at least the proximal portion of the medical device is held by the first proximal sheath, releasing the distal end of the medical device, and releasing the proximal end of the medical device.
17. The method according to claim 16 , wherein the intermediate portion includes a branch member, wherein the branch member is exposed while at least the medical device proximal portion is held in the first proximal sheath.
18. The method according to claim 17 , wherein the medical device proximal portion is covered by the first proximal sheath and the distal portion and branch member are covered by the second distal sheath; the method including the steps of:
splitting the second distal sheath from the proximal end thereof to expose the branch member while the proximal portion of the medical device is held by the first proximal sheath and the distal portion of the medical device is held by the second distal sheath.
19. The method according to claim 16 , including the step of partially retracting the first proximal sheath prior to splitting of the second distal sheath in order to expose the splitting mechanism.
20. The method according to claim 16 , including the step of separating the second distal sheath from the introducer assembly.