PERCUTANEOUS SHUNT DEVICES AND METHODS
The disclosure provides various embodiments of prostheses and delivery systems to permit an interventional cardiologist to create shunts between various blood vessels. Moreover, the disclosed shunts can be used to shunt between various hollow organs, as set forth in the present disclosure.
1 . A medical device comprising:
an elongate inner core member having a proximal end and a distal end, the distal end having a compliant atraumatic tip mounted thereon;
an inflatable member mounted on the elongate inner core member;
a prosthesis mounted around the elongate inner core member; and
a retractable sheath having a proximal end and a distal end, the retractable sheath being slidably disposed with respect to, and covering, the prosthesis and at least a part of the inflatable member;
a first actuator configured and arranged to advance the sheath proximally with respect to the elongate inner core, inflatable member, and prosthesis; and a second actuator coupled to a reservoir of fluid, the reservoir being fluidly coupled to the inflatable member, wherein actuating the second actuator causes the fluid to flow out of the reservoir into the inflatable member to cause the inflatable member to expand radially outwardly.
2 . The medical device of claim 1 , wherein the prosthesis is mounted at least partially over and surrounding the inflatable member.
3 . The medical device of claim 2 , wherein a distal portion of the prosthesis is mounted over the inflatable member.
4 . The medical device of claim 1 , wherein the prosthesis is mounted on the elongate inner core member proximally with respect to the inflatable member.
5 . The medical device of claim 1 , wherein the compliant atraumatic tip includes a gradually tapering distal section that transitions from a larger proximal diameter to a smaller distal diameter.
6 . The medical device of claim 5 , wherein the compliant atraumatic tip further includes a gradually tapering proximal section that transitions from a smaller proximal diameter to a larger distal diameter.
7 . The medical device of claim 6 , wherein a distal end of the proximal section of the compliant atraumatic tip abuts a proximal end of the distal section of the compliant atraumatic tip.
8 . A method of delivering a tubular prosthesis, comprising:
providing the medical device of claim 1 ;
delivering a distal end of the medical device to a target location through the ostium of the first concave vessel wall;
withdrawing the sheath proximally to expose the prosthesis;
positioning the distal end of the prosthesis in the ostium so that the sealing flange and the at least one laterally extending projection are inside the first concave vessel wall and the elongate compliant tubular body extends through the ostium outside of the first vessel;
actuating the second actuator to cause the inflatable member to expand; and
expanding the distal end of the tubular prosthesis using the balloon to fit it into the ostium and to shape the sealing flange to fit against the first concave vessel wall.
9 . The method of claim 8 , wherein the inflatable member is positioned distally with respect to the prosthesis and the inflatable member is inflated to outwardly flare the distal end of the prosthesis.
10 . The method of claim 8 , further comprising adjusting the length of the prosthesis to a desired length, and disposing a proximal end of the prosthesis inside of a second vessel.
11 . The method of claim 10 , wherein the proximal end of the prosthesis is positioned coaxially inside of an end of the second vessel.
12 . The method of claim 10 , wherein the proximal end of the prosthesis is mounted transversely through a second ostium formed in a wall of the second vessel to shunt the first vessel to the second vessel.