Systems and methods for endoluminal valve creation
Systems and methods for creating autologous monocuspid and bicuspid valves can include a catheter having a single expandable element or a double expandable element. Once the leaflets of the valve are created, various techniques can be used to fix the leaflets to the vessel wall or to each other, including clips, tissue anchors, adhesives, and heat.
1. A catheter system for forming a hydrodissection pouch within a vessel wall at a treatment site, wherein the catheter system comprises:
a catheter including:
a proximal end and a distal end, wherein the distal end includes a trough having support rails configured to contact vessel wall tissue at the treatment site; and
a lumen extending from the proximal end to the distal end; and
a dissection assembly configured to be slidably received within the lumen, wherein the dissection assembly includes:
a puncture element having a beveled distal edge, wherein the puncture element is configured to be:
advanced within the vessel wall, and
fluidly coupled to a source of pressurized fluid and eject the pressurized fluid while being advanced within the vessel wall to form the hydrodissection pocket;
a puncture element sheath configured to be advanced distally beyond the beveled edge of the puncture element while the puncture element ejects the pressurized fluid in the vessel wall such that the puncture element sheath shields the tissue of the vessel wall from the puncture element during formation of the hydrodissection pouch; and
a dilator configured to be advanced within the lumen, wherein the dilator has a dilator lumen that is configured to slidably receive the puncture element sheath.
2. The catheter system of claim 1 wherein the dissection assembly further comprises an access sheath configured to be advanced within the lumen, wherein the puncture element sheath is configured to be advanced within the access sheath.
3. The catheter system of claim 1 wherein the dissection assembly further comprises:
an access sheath configured to be slidably received by the lumen,
wherein the dilator is configured to be slidably disposed within the access sheath.
4. The catheter system of claim 1 , further comprising a visualization catheter.
5. The catheter system of claim 1 wherein the trough is configured to slidably receive a visualization catheter.
6. The catheter system of claim 1 wherein the lumen is a first lumen, and wherein the catheter system further comprises a second lumen extending from the proximal end to the distal end, wherein the second lumen is configured to receive a visualization catheter.
7. The catheter system of claim 1 wherein the vessel wall is a vein wall.
8. The catheter system of claim 1 , further comprising a valve creation tool configured to be slidably received within the lumen.
9. The catheter system of claim 1 wherein the catheter further includes an inflation lumen extending from the proximal end to the distal end.
10. The catheter system of claim 1 wherein the catheter further includes an apposition balloon at the distal end.
11. The catheter system of claim 1 wherein the catheter further includes:
an inflation lumen extending from the proximal end to the distal end, and
an apposition balloon at the distal end and fluidly coupled to the inflation lumen.
12. The catheter system of claim 1 wherein the lumen is a first lumen and wherein the catheter further comprises a second lumen extending from the proximal end to the distal end.
13. The catheter system of claim 1 wherein the lumen is a first lumen and wherein the catheter further comprises a second lumen extending from the proximal end to the distal end and a third lumen extending from the proximal end to the distal end.
14. The catheter system of claim 1 wherein the rails have a support surface configured to contact the vessel wall at the treatment site, and wherein the catheter further includes an apposition balloon at the distal end, and further wherein the catheter system is configured such that, when the catheter system is positioned at the treatment site, inflation of the apposition balloon causes the support surface of the rails to contact the vessel wall.