Method for delivering a luminal prosthesis
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 to prevent divarication 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 radial constraint, wherein releasing and expanding occur simultaneously or releasing occurs during expanding.
3. A method as in claim 2 , wherein the radial constraint comprises folds of a balloon covering the anchors, wherein the constraint is released as the balloon is inflated.
4. A method as in claim 2 , wherein the radial constraint comprises a cuff which extends over the anchors.
5. A method as in claim 2 , wherein the constraint comprises a tether which ties the anchors together, wherein the tether is broken by expansion of the scaffold.
6. A method as in claim 1 , wherein the radial constraint is released prior to expanding the scaffold.
7. A method as in claim 6 , wherein the radial constraint comprises a cuff which extends over the anchors, wherein the cuff is withdrawn from the anchors prior to expansion of the scaffold.
8. A method as in claim 7 , wherein prior to withdrawal, the cuff extends over at least a portion of the scaffold.
9. A method as in claim 6 , wherein the radial constraint comprises a tether which ties the anchors together, wherein the tether is withdrawn prior to expansion.
10. A method as in claim 1 , wherein expanding the scaffold deforms the anchors to circumscribe at least a portion of the main-body lumen.
11. A method as in claim 10 , wherein at least three circumferential anchors extend into the main body lumen.
12. A method as in claim 10 , wherein positioning the prosthesis comprises aligning a visible marker on at least one of the prosthesis and a delivery balloon with the os.
13. A method as in claim 10 , wherein the lumens are blood vessels.
14. A method as in claim 10 , wherein the scaffold is expanded with a balloon expanded within the scaffold.
15. A method as in claim 14 , wherein the anchors are deformed by expanding a balloon positioned transversely through the anchors.
16. A method as in claim 15 , wherein the scaffold and anchors are expanded and deformed by the same balloon.
17. A method as in claim 15 , wherein the scaffold and anchors are expanded and deformed by different balloons.
18. A method as in claim 10 , further comprising expanding the second prosthesis within the passage through the anchors.
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 prosthesis supports the anchors over their lengths from the os over the main body lumen wall.
23. A method as in claim 1 , further comprising releasing the radial constraint.
24. 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.
25. 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 to prevent divarication from the delivery catheter;
positioning the prosthesis so that the scaffold lies within the branch body lumen and all of the 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 traverse the Os opening when fully deployed.