External steerable fiber for use in endoluminal deployment of expandable devices
The present disclosure describes treatment of the vasculature of a patient with an expandable implant. The implant is constrained to a reduced delivery diameter for delivery within the vasculature by at least one sleeve. The implant can be constrained to other diameters, such as an intermediate diameter. The sleeves can be expanded, allowing for expansion of the diameter of the expandable implant, by disengaging a coupling member from the sleeve or sleeves from outside of the body of the patient. The expandable implant can comprise a steering line or lines which facilitate bending and steering of the expandable implant through the vasculature of a patient.
1. A method of deploying a stent graft along a vessel having a flow lumen, said method comprising:
providing an expandable stent graft including stent components along a leading portion of a catheter and constraining the stent graft toward a delivery configuration suitable for endoluminal delivery;
actuating a constraint mechanism to allow partial deployment of the stent graft toward an intermediate configuration sized between the delivery configuration and a fully deployed configuration; wherein the constraint mechanism includes a primary sleeve wrapped circumferentially around the expandable stent graft to constrain the expandable stent graft toward the collapsed configuration, the primary sleeve comprising a sheet of material having first and second major surfaces and a plurality of openings extending from the first major surface to the second major surface; and
actuating a steering line, threaded through the expandable stent graft on a first side of the stent components at a first location and on an opposite second side of the stent components at a second location, the steering line arranged in a helical pattern along a length of the expandable stent graft and the steering line at least disposed between the expandable stent graft and the primary sleeve, to form a bend along at least a proximal portion of the stent graft to align at least the proximal portion of the stent graft orthogonally relative to the flow lumen of the vessel.
2. The method as set forth in claim 1 including adjusting a position of the stent graft relative to the vessel while at least a portion of the stent graft remains in the intermediate configuration.
3. The method as set forth in claim 1 including actuating the constraint mechanism to allow expansion of the stent graft toward the fully deployed configuration.
4. The method of claim 1 , wherein the expandable stent graft is self-expanding.
5. The method of claim 1 , wherein the expandable device is balloon expandable.
6. The method of claim 1 including decoupling the steering line from the stent graft.
7. The method of claim 1 including providing a lock wire releasably coupled to the stent graft and the catheter.
8. The method of claim 7 including decoupling the lock wire from the stent graft and the catheter.
9. The method of claim 7 including providing a loop along a portion of the steering line.
10. The method of claim 9 including releasably coupling the steering line to the stent graft by extending the lock wire through the loop in the steering line.
11. The method of claim 10 including decoupling the steering line from the stent graft by removing the lock wire from the loop.
12. The method of claim 1 wherein the bend along the at least a proximal portion of the stent graft is 20 degrees or greater.
13. The method of claim 1 including continuously actuating the steering line to adjust the amount of the bend along the at least a proximal portion of the stent graft.
14. The method of claim 1 , wherein the constraint mechanism includes a primary coupling member cooperating with the openings for releasably coupling portions of the primary sleeve to one another to constrain the expandable stent graft toward the collapsed configuration.
15. The method of claim 14 , wherein the constraint mechanism includes a secondary sleeve and secondary coupling member, wherein the secondary sleeve limits the expansion of the expandable device to the intermediate configuration.
16. The method of claim 1 , wherein the sheet of material is formed from expanded polytetrafluoroethylene (ePTFE).
17. A method of deploying a stent graft along a vessel having a flow lumen, said method comprising:
providing a catheter assembly having a catheter having a leading end and a trailing end and comprising a main lumen extending between the leading end and the trailing end; an expandable stent graft including stent components positioned at the leading end of the catheter, the expandable stent graft having a collapsed configuration for endoluminal delivery of the expandable stent graft to a treatment site and an expanded configuration having a diameter larger than the diameter of the collapsed configuration; a primary sleeve wrapped circumferentially around the expandable stent graft, wherein the primary sleeve comprises a sheet of material having first and second major surfaces and a plurality of openings extending from the first major surface to the second major surface; a primary coupling member cooperating with the openings for releasably coupling portions of the sheet to one another to constrain the expandable stent graft toward the collapsed configuration; and at least one steering line threaded through the expandable stent graft on a first side of the stent components at a first location and on an opposite second side of the stent components at a second location, the at least one steering line arranged in a helical pattern along a length of the expandable stent graft and extending through the main lumen of the catheter and at least disposed between the expandable stent graft and the primary sleeve to allow selective bending of the expandable stent graft and non-concentric engagement of the expandable implant in relation to the catheter;
positioning the expandable stent graft at or near a desired location along the vessel;
displacing the primary coupling member from the openings to allow the expandable stent graft to expand outwardly from the collapsed configuration; and
actuating the at least one steering line to form a bend along at least a proximal portion of the expandable stent graft to align at least the proximal portion of the expandable stent graft orthogonally relative with respect to the flow lumen of the vessel.
18. The method of claim 17 , wherein the catheter assembly includes a secondary sleeve and secondary coupling member, wherein the secondary sleeve limits the expansion of the expandable stent graft to an intermediate configuration having a diameter larger than the diameter of the collapsed configuration and smaller than the diameter of the expanded configuration.
19. The method of claim 18 , wherein the at least one steering line is disposed within the secondary sleeve such that when the catheter assembly is inserted into a vessel, the at least one steering line remains covered by the secondary sleeve.
20. The method of claim 18 , wherein the at least one steering line torsionally anchors the expandable stent graft and catheter allowing rotational positioning of device at treatment site via rotation of catheter.