Device for controllably deploying expandable implants
Aspects of the present invention relate to a delivery device for locating an expandable implant for treating BPH within the prostatic urethra of a patient. The delivery device comprises an inner tube and an outer sleeve movable relative to the inner tube between a stored position and a deployed position. The outer sleeve surrounds the inner tube to define an annulus therebetween and the expandable implant is retained within the annulus when the outer sleeve is in the stored position.
1 . A system for treating a prostatic urethra, the system comprising:
an implant self-expandable from a contracted state to an expanded state; and
an implant delivery device comprising:
a handle comprising an actuator;
an outer sheath extending distally from the handle and insertable into a urethra, the outer sheath comprising a hollow distal end holding the implant in the contracted state;
an inner tube comprising an implant holder, wherein the outer sheath is configured to partially move longitudinally relative to the implant holder upon a first operation of the actuator to uncover a distal segment of the implant while the outer sheath covers a proximal segment of the implant, the implant holder comprising a retention formation configured to inhibit rotational and longitudinal movement of the implant relative to the implant holder and configured to retain the implant in the outer sleeve when the distal segment of the implant is uncovered and the proximal segment of the implant is covered, the outer sleeve configured to fully move longitudinally relative to the implant holder configured upon a second operation of the actuator to uncover the proximal segment of the implant and deploy the implant from the outer sleeve, the retention formation comprising:
a proximal protrusion configured to inhibit proximal movement of the implant in the delivery device,
a distal protrusion configured to inhibit distal movement of the implant in the delivery device, and
the proximal protrusion and the distal protrusion forming a slot configured to inhibit rotational movement of the implant in the delivery device,
wherein a portion of the implant is in the slot; and
an imaging device movable with the outer sheath and configured to allow imaging of the urethra and the implant while the outer sheath covers the proximal segment of the implant, including rotationally orienting the implant with respect to anatomical features of the urethra,
wherein the retention formation comprises a plurality of distal protrusions including the distal protrusion.
2 . A system for treating a prostatic urethra, the system comprising:
an implant self-expandable from a contracted state to an expanded state; and
an implant delivery device comprising:
a handle comprising an actuator;
an outer sheath extending distally from the handle and insertable into a urethra, the outer sheath comprising a hollow distal end holding the implant in the contracted state;
an inner tube comprising an implant holder, wherein the outer sheath is configured to partially move longitudinally relative to the implant holder upon a first operation of the actuator to uncover a distal segment of the implant while the outer sheath covers a proximal segment of the implant, the implant holder comprising a retention formation configured to inhibit rotational and longitudinal movement of the implant relative to the implant holder and configured to retain the implant in the outer sleeve when the distal segment of the implant is uncovered and the proximal segment of the implant is covered, the outer sleeve configured to fully move longitudinally relative to the implant holder configured upon a second operation of the actuator to uncover the proximal segment of the implant and deploy the implant from the outer sleeve, the retention formation comprising:
a proximal protrusion configured to inhibit proximal movement of the implant in the delivery device,
a distal protrusion configured to inhibit distal movement of the implant in the delivery device, and
the proximal protrusion and the distal protrusion forming a slot configured to inhibit rotational movement of the implant in the delivery device,
wherein a portion of the implant is in the slot; and
an imaging device movable with the outer sheath and configured to allow imaging of the urethra and the implant while the outer sheath covers the proximal segment of the implant, including rotationally orienting the implant with respect to anatomical features of the urethra,
wherein the proximal protrusion comprises a circumferential shoulder longitudinally spaced from the distal protrusion.
3 . A system for treating a prostatic urethra, the system comprising:
an implant self-expandable from a contracted state to an expanded state; and
an implant delivery device comprising:
a handle comprising an actuator;
an outer sheath extending distally from the handle and insertable into a urethra, the outer sheath comprising a hollow distal end holding the implant in the contracted state;
a cylindrical elongate inner element comprising an implant holder, the outer sleeve configured to partially move longitudinally relative to the implant holder upon a first operation of the actuator to uncover a distal segment of the implant while the outer sheath covers a proximal segment of the implant, the implant holder comprising a retention formation configured to inhibit rotational and longitudinal movement of the implant relative to the implant holder and configured to retain the implant in the outer sleeve when the distal segment of the implant is uncovered and the proximal segment of the implant is covered, the outer sleeve configured to fully move longitudinally relative to the implant holder upon a second operation of the actuator to uncover the proximal segment of the implant and deploy the implant from the outer sleeve; and
an imaging device movable with the outer sheath and configured to allow imaging of the urethra and the implant while the outer sheath covers the proximal segment of the implant,
wherein the cylindrical elongate inner element comprises a tube comprising a lumen.
4 . The system of claim 3 , wherein the retention formation comprises:
a proximal protrusion configured to inhibit proximal movement of the implant in the delivery device,
a distal protrusion configured to inhibit distal movement of the implant in the delivery device, and
the proximal protrusion forming a slot configured to inhibit rotational movement of the implant in the delivery device,
wherein a portion of the implant is in the slot.
5 . The system of claim 4 , wherein the retention formation comprises a plurality of distal protrusions including the distal protrusion.
6 . A system for treating a prostatic urethra, the system comprising:
an implant self-expandable from a contracted state to an expanded state; and
an implant delivery device comprising:
a handle comprising an actuator;
an outer sheath extending distally from the handle and insertable into a urethra, the outer sheath comprising a hollow distal end holding the implant in the contracted state;
a cylindrical elongate inner element comprising an implant holder, the outer sleeve configured to partially move longitudinally relative to the implant holder upon a first operation of the actuator to uncover a distal segment of the implant while the outer sheath covers a proximal segment of the implant, the implant holder comprising a retention formation configured to inhibit rotational and longitudinal movement of the implant relative to the implant holder and configured to retain the implant in the outer sleeve when the distal segment of the implant is uncovered and the proximal segment of the implant is covered, the outer sleeve configured to fully move longitudinally relative to the implant holder upon a second operation of the actuator to uncover the proximal segment of the implant and deploy the implant from the outer sleeve; and
an imaging device movable with the outer sheath and configured to allow imaging of the urethra and the implant while the outer sheath covers the proximal segment of the implant,
wherein the retention formation comprises:
a radial protrusion; and
a circumferential shoulder longitudinally spaced from the radial protrusion,
wherein a portion of the implant is configured to be positioned between the radial protrusion and the circumferential shoulder.
7 . The system of claim 6 , wherein the retention formation comprises a plurality of distal protrusions including the distal protrusion.
8 . A system for treating a prostatic urethra, the system comprising:
an implant self-expandable from a contracted state to an expanded state; and
an implant delivery device comprising:
a handle comprising an actuator;
an outer sheath extending distally from the handle and insertable into a urethra, the outer sheath comprising a hollow distal end holding the implant in the contracted state;
a cylindrical elongate inner element comprising an implant holder, the outer sleeve configured to partially move longitudinally relative to the implant holder upon a first operation of the actuator to uncover a distal segment of the implant while the outer sheath covers a proximal segment of the implant, the implant holder comprising a retention formation configured to inhibit rotational and longitudinal movement of the implant relative to the implant holder and configured to retain the implant in the outer sleeve when the distal segment of the implant is uncovered and the proximal segment of the implant is covered, the outer sleeve configured to fully move longitudinally relative to the implant holder upon a second operation of the actuator to uncover the proximal segment of the implant and deploy the implant from the outer sleeve; and
an imaging device movable with the outer sheath and configured to allow imaging of the urethra and the implant while the outer sheath covers the proximal segment of the implant,
wherein the imaging device is configured to facilitate rotationally orienting the implant with respect to anatomical features of the urethra.
9 . A system for treating a prostatic urethra, the system comprising:
an implant self-expandable from a contracted state to an expanded state; and
an implant delivery device comprising:
a handle comprising an actuator;
an outer sheath extending distally from the handle and insertable into a urethra, the outer sheath comprising a hollow distal end holding the implant in the contracted state; and
an elongate inner element comprising an implant holder, the outer sleeve configured to partially move longitudinally relative to the implant holder upon a first operation of the actuator to uncover a distal segment of the implant while the outer sheath covers a proximal segment of the implant, the implant holder comprising a retention formation configured to inhibit rotational and longitudinal movement of the implant relative to the implant holder and configured to retain the implant in the outer sleeve when the distal segment of the implant is uncovered and the proximal segment of the implant is covered, the outer sleeve configured to fully move longitudinally relative to the implant holder upon a second operation of the actuator to uncover the proximal segment of the implant and deploy the implant from the outer sleeve,
wherein the elongate inner element is cylindrical.
10 . The system of claim 9 , wherein the retention formation comprises:
a proximal protrusion configured to inhibit proximal movement of the implant in the delivery device,
a distal protrusion configured to inhibit distal movement of the implant in the delivery device, and
the proximal protrusion and the distal protrusion forming a slot configured to inhibit rotational movement of the implant in the delivery device,
wherein a portion of the implant is in the slot.
11 . The system of claim 10 , wherein the retention formation comprises a plurality of distal protrusions including the distal protrusion.
12 . The system of claim 11 , wherein the retention formation comprises two distal protrusions including the distal protrusion.
13 . The system of claim 11 , wherein the distal protrusions of the plurality of distal protrusions are spaced angularly on the elongate inner element by 120°.
14 . The system of claim 9 , wherein the elongate inner element comprises a rod.
15 . The system of claim 9 , further comprising an imaging device movable with the outer sheath and configured to allow imaging of the urethra and the implant while the outer sheath covers the proximal segment of the implant.
16 . The system of claim 15 , wherein the imaging device is configured to allow rotationally orienting the implant with respect to anatomical features of the urethra.
17 . A system for treating a prostatic urethra, the system comprising:
an implant self-expandable from a contracted state to an expanded state; and
an implant delivery device comprising:
a handle comprising an actuator;
an outer sheath extending distally from the handle and insertable into a urethra, the outer sheath comprising a hollow distal end holding the implant in the contracted state; and
an elongate inner element comprising an implant holder, the outer sleeve configured to partially move longitudinally relative to the implant holder upon a first operation of the actuator to uncover a distal segment of the implant while the outer sheath covers a proximal segment of the implant, the implant holder comprising a retention formation configured to inhibit rotational and longitudinal movement of the implant relative to the implant holder and configured to retain the implant in the outer sleeve when the distal segment of the implant is uncovered and the proximal segment of the implant is covered, the outer sleeve configured to fully move longitudinally relative to the implant holder upon a second operation of the actuator to uncover the proximal segment of the implant and deploy the implant from the outer sleeve,
wherein the retention formation comprises:
a radial protrusion; and
a circumferential shoulder longitudinally spaced from the radial protrusion,
wherein a portion of the implant is configured to be positioned between the radial protrusion and the circumferential shoulder.
18 . The system of claim 17 , wherein the retention formation comprises a plurality of distal protrusions including the distal protrusion.
19 . The system of claim 18 , wherein the distal protrusion comprises a proximal plateau and a distal ramp.
20 . A system for treating a prostatic urethra, the system comprising:
an implant self-expandable from a contracted state to an expanded state; and
an implant delivery device comprising:
a handle comprising an actuator;
an outer sheath extending distally from the handle and insertable into a urethra, the outer sheath comprising a hollow distal end holding the implant in the contracted state; and
an elongate inner element comprising an implant holder, the outer sleeve configured to partially move longitudinally relative to the implant holder upon a first operation of the actuator to uncover a distal segment of the implant while the outer sheath covers a proximal segment of the implant, the implant holder comprising a retention formation configured to inhibit rotational and longitudinal movement of the implant relative to the implant holder and configured to retain the implant in the outer sleeve when the distal segment of the implant is uncovered and the proximal segment of the implant is covered, the outer sleeve configured to fully move longitudinally relative to the implant holder upon a second operation of the actuator to uncover the proximal segment of the implant and deploy the implant from the outer sleeve,
wherein the elongate inner element comprises a tube comprising a lumen.
21 . A system for treating a prostatic urethra, the system comprising:
an implant self-expandable from a contracted state to an expanded state; and
an implant delivery device comprising:
a handle comprising an actuator;
an outer sheath extending distally from the handle and insertable into a urethra, the outer sheath comprising a hollow distal end holding the implant in the contracted state; and
an elongate inner element comprising an implant holder, the outer sleeve configured to partially move longitudinally relative to the implant holder upon a first operation of the actuator to uncover a distal segment of the implant while the outer sheath covers a proximal segment of the implant, the implant holder comprising a retention formation configured to inhibit rotational and longitudinal movement of the implant relative to the implant holder and configured to retain the implant in the outer sleeve when the distal segment of the implant is uncovered and the proximal segment of the implant is covered, the outer sleeve configured to fully move longitudinally relative to the implant holder upon a second operation of the actuator to uncover the proximal segment of the implant and deploy the implant from the outer sleeve,
wherein the retention formation comprises:
a proximal protrusion configured to inhibit proximal movement of the implant in the delivery device,
a plurality of distal protrusions configured to inhibit distal movement of the implant in the delivery device, each distal protrusion of the plurality of distal protrusions comprising a proximal plateau and a distal ramp, wherein the distal protrusions of the plurality of distal protrusions are spaced angularly on the elongate inner element by 120°, and
the proximal protrusion and the plurality of distal protrusions forming form a plurality of slots configured to inhibit rotational movement of the implant in the delivery device,
wherein a portion of the implant engages the plurality of slots.
22 . A delivery device for deploying a self-expanding implant within a body cavity, the device comprising:
at least one retention formation for holding the implant against axial or circumferential movement;
an elongate longitudinally-extending outer element, radially outboard of the at least one retention formation; and
an imaging head disposed on a longitudinal axis that extends on a radially-inboard side of the at least one retention formation;
wherein the outer element is movable longitudinally relative to the at least one retention formation between:
a storage position in which the outer element surrounds the implant and holds the implant engaged with the at least one retention formation; and
a partial-deployment position in which the outer element uncovers a distal portion of the implant while surrounding a proximal portion of the implant to continue holding the implant engaged with the at least one retention formation;
wherein the imaging head is movable longitudinally between:
an advanced position when the outer element is in the storage position; and
a retracted position when the outer element is in the partial-deployment position,
wherein the outer element is movable longitudinally, relative to the at least one retention formation, into a full-deployment position in which the outer element uncovers the proximal portion of the implant to an extent sufficient to disengage the implant from the retention formation for radial self expansion within the body cavity; and
a detent that is arranged to selectively control, disable and enable movement of the outer element into the full-deployment position, wherein the detent comprises a path and an extension configured to follow the path, the path comprising a detent range beyond which movement of the extension in a longitudinal direction is restricted, the extension movable beyond the detent range by deliberate relative movement between the extension and the path,
wherein the detent is further arranged selectively to control, disable and enable movement of the outer element from the storage position into the partial-deployment position, and wherein the detent is further arranged to selectively control, disable and enable movement of the imaging head.
23 . The device of claim 22 , wherein the deliberate relative movement is in a second direction transverse to the longitudinal direction.
24 . A delivery device for deploying a self-expanding implant within a body cavity, the device comprising:
at least one retention formation for holding the implant against axial or circumferential movement;
an elongate longitudinally-extending outer element, radially outboard of the at least one retention formation; and
an imaging head disposed on a longitudinal axis that extends on a radially-inboard side of the at least one retention formation;
wherein the outer element is movable longitudinally relative to the at least one retention formation between:
a storage position in which the outer element surrounds the implant and holds the implant engaged with the at least one retention formation; and
a partial-deployment position in which the outer element uncovers a distal portion of the implant while surrounding a proximal portion of the implant to continue holding the implant engaged with the at least one retention formation;
wherein the imaging head is movable longitudinally between:
an advanced position when the outer element is in the storage position; and
a retracted position when the outer element is in the partial-deployment position,
wherein the outer element is movable longitudinally, relative to the at least one retention formation, into a full-deployment position in which the outer element uncovers the proximal portion of the implant to an extent sufficient to disengage the implant from the retention formation for radial self expansion within the body cavity; and
a detent that is arranged to selectively control, disable and enable movement of the outer element into the full-deployment position, wherein the detent comprises a path and an extension configured to follow the path, the path comprising a detent range beyond which movement of the extension in a longitudinal direction is restricted, the extension movable beyond the detent range by deliberate relative movement between the extension and the path,
wherein the imaging head is configured to define a field of view, and wherein the field of view encompasses at least a distal end of the implant when the imaging head is in the retracted position.
25 . A system for treating a prostatic urethra, the system comprising:
an implant self-expandable from a contracted state to an expanded state; and
an implant delivery device comprising:
a handle comprising an actuator;
an outer sheath extending distally from the handle and insertable into a urethra, the outer sheath comprising a hollow distal end holding the implant in the contracted state;
a cylindrical elongate inner element comprising an implant holder, the outer sleeve configured to partially move longitudinally relative to the implant holder upon a first operation of the actuator to uncover a distal segment of the implant while the outer sheath covers a proximal segment of the implant, the implant holder comprising a retention formation configured to inhibit rotational and longitudinal movement of the implant relative to the implant holder and configured to retain the implant in the outer sleeve when the distal segment of the implant is uncovered and the proximal segment of the implant is covered, the outer sleeve configured to fully move longitudinally relative to the implant holder upon a second operation of the actuator to uncover the proximal segment of the implant and deploy the implant from the outer sleeve; and
an imaging device movable with the outer sheath and configured to allow imaging of the urethra and the implant while the outer sheath covers the proximal segment of the implant,
wherein the retention formation comprises:
a proximal protrusion configured to inhibit proximal movement of the implant in the delivery device,
a distal protrusion configured to inhibit distal movement of the implant in the delivery device, and
the proximal protrusion forming a slot configured to inhibit rotational movement of the implant in the delivery device,
wherein a portion of the implant is in the slot,
wherein the retention formation comprises a plurality of distal protrusions including the distal protrusion.
26 . A system for treating a prostatic urethra, the system comprising:
an implant self-expandable from a contracted state to an expanded state; and
an implant delivery device comprising:
a handle comprising an actuator;
an outer sheath extending distally from the handle and insertable into a urethra, the outer sheath comprising a hollow distal end holding the implant in the contracted state; and
an elongate inner element comprising an implant holder, the outer sleeve configured to partially move longitudinally relative to the implant holder upon a first operation of the actuator to uncover a distal segment of the implant while the outer sheath covers a proximal segment of the implant, the implant holder comprising a retention formation configured to inhibit rotational and longitudinal movement of the implant relative to the implant holder and configured to retain the implant in the outer sleeve when the distal segment of the implant is uncovered and the proximal segment of the implant is covered, the outer sleeve configured to fully move longitudinally relative to the implant holder upon a second operation of the actuator to uncover the proximal segment of the implant and deploy the implant from the outer sleeve,
wherein the retention formation comprises:
a proximal protrusion configured to inhibit proximal movement of the implant in the delivery device,
a distal protrusion configured to inhibit distal movement of the implant in the delivery device, and
the proximal protrusion and the distal protrusion forming a slot configured to inhibit rotational movement of the implant in the delivery device,
wherein a portion of the implant is in the slot,
wherein the retention formation comprises a plurality of distal protrusions including the distal protrusion.