System and methods for treating a bifurcation
A system for treating a bifurcation includes first and second delivery catheters, each having an expandable member and a stent. The stent on the second delivery catheter has a side hole. A portion of the first delivery catheter is disposed under a portion of the stent on second delivery catheter. The first delivery catheter is slidable relative to the second delivery catheter, and the first delivery catheter passes through the side hole.
1. A method for treating a bifurcated vessel, said method comprising:
simultaneously advancing a first and a second delivery catheter through a mother vessel toward a bifurcation,
wherein the mother vessel bifurcates into a first daughter vessel and a second daughter vessel, the first daughter vessel having a diameter larger than a diameter of the second daughter vessel,
wherein the first delivery catheter comprises a first elongate shaft having a first expandable member disposed adjacent a distal end of the first elongate shaft and a first stent coupled to the first expandable member,
wherein the second delivery catheter comprises a second elongate shaft having a second expandable member disposed adjacent a distal end of the second elongate shaft and a second stent coupled to the second expandable member, the second stent further comprising a side hole extending through a side wall of the second stent, and
wherein the first expandable member is distal of the second expandable member during the advancement;
disposing a distal portion of the second stent in the second daughter vessel while a proximal portion of the second stent remains in the mother vessel;
disposing the first stent in the first daughter vessel;
proximally retracting the first delivery catheter through the side hole and under a proximal portion of the second stent;
radially expanding the first expandable member thereby simultaneously expanding the first stent to engage a wall of the first daughter vessel and the proximal portion of the second stent to engage a wall of the mother vessel; and
radially expanding the second expandable member thereby expanding the second stent to engage a wall of the second daughter vessel.
2. The method of claim 1 , wherein the first daughter vessel and the second daughter vessel form a bifurcation angle therebetween, the bifurcation angle greater than or equal to 60-70 degrees.
3. The method of claim 1 , further comprising simultaneously radially expanding the first expandable member and the second expandable member to expand the second stent into apposition with the wall of the mother vessel and the wall of the second daughter vessel, and to expand the first stent into apposition with the wall of the first daughter vessel.
4. The method of claim 1 , wherein advancing the first and the second delivery catheters comprise slidably advancing the first delivery catheter over a first guidewire and slidably advancing the second delivery catheter over a second guidewire.
5. The method of claim 1 , wherein the first guidewire is disposed in the first daughter vessel, and the second guidewire is disposed in the second daughter vessel.
6. The method of claim 1 , wherein proximally retracting the first delivery catheter comprises abutting or interleaving a proximal end of the first stent with the second stent.
7. The method of claim 6 , wherein the proximal end of the first stent abuts or interleaves with the side wall of the second stent.
8. The method of claim 1 , wherein proximally retracting the first delivery catheter comprises aligning a radiopaque marker on a the first delivery catheter with a radiopaque marker on the second delivery catheter.
9. The method of claim 1 , wherein radially expanding the first expandable member or the second expandable member comprises inflating a balloon.