Delivery system for placement of prosthesis at luminal OS
An embodiment of the invention provides a prosthesis delivery system comprising a delivery catheter having an expandable member and a prosthesis carried over the expandable member. The prosthesis includes a radially expandable scaffold section and at least two anchors extending axially from an end thereof; and means for capturing at least the anchors to prevent the anchors from divaricating from the expandable member as the catheter is advanced through a patient's vasculature.
1. A method for delivering a luminal prosthesis, said method comprising:
providing a delivery catheter which carries the prosthesis, wherein the prosthesis comprises a radially expansible scaffold section, at least two anchors each having a distal end coupled with a proximal end of the scaffold section, and at least one opening extending through a side wall of the prosthesis between the at least two anchors and between the scaffold and proximal ends of the anchors, wherein, when expanded, the opening defines a passage;
advancing the delivery catheter to position the prosthesis at a target location in a body lumen, the target location including an Os opening from a main body lumen to a branch body lumen, wherein at least the anchors are radially constrained by a capturing structure to prevent divarication from the delivery catheter and the scaffold is not radially constrained by a structure that is separable from the delivery catheter;
positioning the prosthesis so that the scaffold lies within the branch body lumen and all of the anchors extend into the main body lumen;
expanding the scaffold within the branch body lumen and expanding at least two anchors so that all of the anchors extend into and in a same upstream blood flow direction within the main body lumen when expanded; and
deploying a second prosthesis within the passage through the at least one opening.
2. A method as in claim 1 , further comprising releasing the capturing structure.
3. A method as in claim 2 , wherein releasing and expanding occur simultaneously or releasing occurs during expanding.
4. A method as in claim 3 , wherein the capturing structure comprises folds of a balloon covering the anchors, wherein the capturing structure is released as the balloon is inflated.
5. A method as in claim 3 , wherein the capturing structure comprises a cuff which extends over the anchors.
6. A method as in claim 3 , wherein the capturing structure comprises a tether which ties the anchors together, wherein the tether is broken by expansion of the scaffold.
7. A method as in claim 2 , wherein the capturing structure is released prior to expanding the scaffold.
8. A method as in claim 7 , wherein the capturing structure comprises a cuff which extends over the anchors, wherein the cuff is withdrawn from the anchors prior to expansion of the scaffold.
9. A method as in claim 8 , wherein prior to withdrawal, the cuff extends over at least a portion of the scaffold.
10. A method as in claim 7 , wherein the capturing structure comprises a tether which ties the anchors together, wherein the tether is withdrawn prior to expansion.
11. A method as in claim 1 , wherein expanding the scaffold deforms the anchors to circumscribe at least a portion of the main-body lumen.
12. A method as in claim 11 , wherein at least three circumferential anchors extend into the main body lumen.
13. A method as in claim 11 , wherein positioning the prosthesis comprises aligning a visible marker on at least one of the prosthesis and a delivery balloon with the os.
14. A method as in claim 11 , wherein the lumens are blood vessels.
15. A method as in claim 11 , wherein the scaffold is expanded with a balloon expanded within the scaffold.
16. A method as in claim 15 , wherein the anchors are deformed by expanding a balloon positioned transversely through the anchors.
17. A method as in claim 16 , wherein the scaffold and anchors are expanded and deformed by the same balloon.
18. A method as in claim 16 , wherein the scaffold and anchors are expanded and deformed by different balloons.
19. A method as in claim 1 , further comprising:
circumferentially deforming the anchors to circumscribe at least a portion of a wall of the main body lumen and open the passage through the anchors.
20. A method as in claim 1 , wherein the second prosthesis is deployed by a balloon catheter exchanged over a guidewire pre-positioned for deformation of the anchors.
21. A method as in claim 1 , wherein the anchors are deformed by deployment of the second prosthesis.
22. A method as in claim 1 , wherein the deployed second stent supports the anchors over their lengths from the os over the main body lumen wall.
23. The method of claim 1 , further comprising circumferentially deforming the anchors such that the anchors circumscribe the main body lumen to reach a wall of the main body lumen opposite the Os opening.
24. A method for delivering a luminal prosthesis, said method comprising:
providing a delivery catheter which carries the prosthesis, wherein the prosthesis comprises a radially expansible scaffold section and at least two anchors each extending directly from an end thereof;
advancing the delivery catheter to position the prosthesis at a target location in a body lumen, the target location including an Os opening from a main body lumen to a branch body lumen, wherein at least the anchors are radially constrained by a capturing structure to prevent divarication from the delivery catheter and the scaffold is not radially constrained by a structure that is separable from the delivery catheter;
positioning the prosthesis so that the scaffold lies within the branch body lumen and the at least two anchors traverse the Os opening and extend into the main body lumen; and
expanding the scaffold within the branch body lumen and expanding at least two anchors so that all of the anchors extend into and in a same upstream blood flow direction within the main body lumen and the at least two anchors traverse the Os opening when fully deployed.