Apparatus and methods for delivering prostheses to luminal bifurcations
A catheter for delivering luminal prostheses comprises a catheter body having an expandable member near a distal end. The prosthesis has a side hole, and a guidewire extends beneath a proximal portion of the prosthesis and over the exterior of the expandable member. A distal end of the guidewire is retracted proximally from the closest point on the side opening to reduce possible interference with catheter advancement.
1. A delivery catheter comprising:
a catheter shaft having a proximal end and a distal end;
an expansion member disposed near the distal end of the shaft;
an expandable prosthesis having a side hole and being mounted over the expansion member;
a guidewire tube disposed over the expansion member and beneath a proximal portion of the expandable prosthesis, the guidewire tube having a distal end positioned at a holding location spaced proximally of the side hole of the prosthesis; and
a side guidewire slidably received within a lumen of the guidewire tube, the side guidewire being advanceable beyond the distal end of the guidewire tube to extend out of the side hole of the expandable prosthesis,
wherein the side hole of the prosthesis comprises an enlarged cell distinguishable from the adjacent or remaining structure of the prosthesis, and
wherein the side hole of the prosthesis is configured to bridge the circumference of a side branch ostium after the prosthesis is expanded in a main branch vessel.
2. A delivery catheter as in claim 1 wherein the side guidewire is slidably received in a channel of an elongate slide.
3. A delivery catheter as in claim 1 , wherein the guidewire tube consists essentially of the side guidewire which directly contacts an inner wall of the prosthesis and an outer surface of the expansion member.
4. A delivery catheter as in claim 1 , further comprising a central guidewire extending distally from the distal end of the catheter shaft.
5. A delivery catheter as in claim 4 , wherein the central guidewire is fixed.
6. A delivery catheter as in claim 4 , wherein the central guidewire is moveable.
7. A delivery catheter as in claim 1 , wherein the expandable prosthesis comprises a radiopaque marker adjacent the side hole of the prosthesis.
8. A delivery catheter as in claim 1 , wherein the catheter shaft is adapted to transmit torque such that rotating the proximal end rotates the expandable prosthesis disposed near the distal end.
9. A delivery catheter as in claim 1 , wherein the catheter shaft is adapted to self align as the shaft is advanced through the main branch vessel.
10. A delivery catheter as in claim 1 , wherein the catheter shaft comprises a distal section, an intermediate section, and a proximal section, wherein at least one of the distal and intermediate sections is more flexible than the proximal section.
11. A delivery catheter as in claim 10 , wherein the proximal section of the catheter shaft is rounded.
12. A delivery catheter as in claim 10 , wherein the intermediate section of the catheter shaft is rounded and has a reduced diameter relative to the proximal section of the catheter shaft.
13. A delivery catheter as in claim 10 , wherein the distal section of the catheter shaft is flat.
14. A delivery catheter as in claim 1 , wherein the guidewire tube is configured to constrain the guidewire during advancement of the delivery catheter into the main branch vessel.
15. A delivery catheter as in claim 1 , wherein the guidewire comprises an atraumatic distal sphere.
16. A delivery catheter as in claim 1 , the side guidewire comprises a radiopaque marker.
17. A delivery catheter as in claim 16 , wherein the radiopaque marker comprises a radiopaque coil.
18. A delivery catheter as in claim 1 , wherein the guidewire tube has an open top half.