U.S. patent application number 13/453000 was filed with the patent office on 2012-08-16 for bifurcation catheter dual balloon bond and methods.
This patent application is currently assigned to BOSTON SCIENTIFIC SCIMED, INC.. Invention is credited to Mary Bronson, Matt Heidner, Katherine Prindle, Karen Turner.
Application Number | 20120209367 13/453000 |
Document ID | / |
Family ID | 41090295 |
Filed Date | 2012-08-16 |
United States Patent
Application |
20120209367 |
Kind Code |
A1 |
Prindle; Katherine ; et
al. |
August 16, 2012 |
BIFURCATION CATHETER DUAL BALLOON BOND AND METHODS
Abstract
A catheter assembly includes a main catheter branch having a
catheter shaft and a distal end portion. A main balloon and a side
balloon are positioned at the distal end portion of the catheter
shaft. The main balloon includes a distal waist portion at a distal
end thereof and a proximal waist portion at a proximal end thereof.
The side balloon includes an inflatable portion, a proximal waist
portion, and a distal waist portion, wherein the proximal and
distal waist portions define a side inflation lumen. The proximal
waist portion of the side balloon and the proximal waist portion of
the main balloon are secured to the distal end portion of the
catheter shaft at a single bond or connection point to create a
proximal balloon joint, wherein the main inflation lumen is in
fluid communication with the main balloon and the side inflation
lumen.
Inventors: |
Prindle; Katherine;
(Robbinsdale, MN) ; Turner; Karen; (Lino Lakes,
MN) ; Bronson; Mary; (Elk River, MN) ;
Heidner; Matt; (Maple Grove, MN) |
Assignee: |
BOSTON SCIENTIFIC SCIMED,
INC.
Maple Grove
MN
|
Family ID: |
41090295 |
Appl. No.: |
13/453000 |
Filed: |
April 23, 2012 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
|
|
12183869 |
Jul 31, 2008 |
8163123 |
|
|
13453000 |
|
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Current U.S.
Class: |
623/1.11 ;
604/101.01 |
Current CPC
Class: |
A61F 2/958 20130101;
A61M 25/1025 20130101; A61F 2002/821 20130101; A61M 25/1011
20130101; A61M 2025/1045 20130101; A61F 2/954 20130101; A61F 2/856
20130101; A61M 25/104 20130101; A61M 25/1034 20130101 |
Class at
Publication: |
623/1.11 ;
604/101.01 |
International
Class: |
A61F 2/84 20060101
A61F002/84; A61M 29/00 20060101 A61M029/00 |
Claims
1. A catheter assembly, comprising: a main catheter branch,
including: a catheter shaft having a proximal end portion, a distal
end portion, the distal end portion defining a main inflation
member, the catheter shaft having a main guidewire housing having a
distal end portion, the distal end portion of the main guidewire
housing extending distally beyond the distal end portion of the
catheter shaft; a main balloon having a distal waist at a distal
end portion thereof and a proximal waist at a proximal end portion
thereof, the proximal waist mounted to the catheter shaft and the
distal waist mounted to the distal end portion of the main
guidewire housing; and a side balloon having an inflatable portion,
a distal waist at a distal end portion thereof, and a proximal
waist at a proximal end portion thereof, the side balloon being
configured to extend in a radial direction relative to the main
balloon when the side balloon is inflated, the inflatable portion
positioned at a location between the proximal and distal end
portions of the main balloon, wherein the proximal waist of the
side balloon, the proximal waist of the main balloon, and the
distal end portion of the catheter shaft are joined at a single
joint such that the side balloon and the main balloon are in fluid
communication with the main inflation member of the main catheter
shaft, wherein a distal end point of the catheter shaft extends
inside the proximal waist of the main balloon such that the distal
end point of the catheter shaft resides at a distal end point of
the proximal waist of the main balloon.
2. The assembly of claim 1, wherein the distal waist of the side
balloon is mounted to the distal end portion of the main guidewire
housing.
3. The assembly of claim 1, further comprising a stent, the stent
having opposing proximal and distal open ends, and a lateral branch
opening, the lateral branch opening positioned at a location
between the proximal and distal open ends, wherein the stent is
operably mounted to the main balloon with the side balloon
inflatable portion oriented in alignment with the lateral branch
opening.
4. The assembly of claim 1, wherein the single joint is positioned
proximal of the distal end point of the catheter shaft a distance
in the range of about 1 mm to about 10 mm inclusive.
5. The assembly of claim 3, further comprising a side catheter
branch having a distal end portion, the side catheter branch
defining a branch guidewire lumen, the distal end portion of the
side catheter branch extending through the lateral branch opening
of the stent prior to inflation of the main balloon and the side
balloon.
6. The assembly of claim 1, wherein the single joint is bonded
together with a heat bond connection.
7. The assembly of claim 1, wherein the single joint is bonded
together with a laser bond connection.
8. A catheter assembly, comprising: a main catheter branch having a
proximal end portion and a distal end portion, the distal end
portion including: a catheter shaft having a distal end portion
with a distal end point and defining a main inflation lumen; a main
guidewire housing having a distal end portion extending distally
beyond the distal end point of the catheter shaft, the guidewire
housing defining a main guidewire lumen; a main balloon having a
proximal waist portion mounted to the catheter shaft and a distal
waist portion mounted to the distal end portion of the main
guidewire housing; a side balloon having an inflatable portion, a
proximal waist portion, and a distal waist portion, the proximal
and distal waist portions of the side balloon defining a side
inflation lumen, wherein the proximal waist portion of the side
balloon, the proximal waist portion of the main balloon, and the
distal end portion of the catheter shaft are joined at a single
location such that the main balloon and side balloon are in fluid
communication with the main inflation lumen, wherein the distal end
point of the catheter shaft extends inside the proximal waist
portion of the main balloon such that the distal end point of the
catheter shaft resides at a distal end point of the proximal waist
portion of the main balloon; a side catheter branch having a distal
end portion, the side catheter branch defining a side guidewire
lumen; and a stent, the stent having proximal and distal open ends,
and a lateral branch opening defined in the stent at a location
between the proximal and distal open ends, the distal end portion
of the side catheter branch extending through the lateral branch
opening prior to inflation of the main balloon and the side
balloon.
9. The assembly of claim 8, wherein the single location is
positioned proximal of the distal end point of the catheter shaft a
distance in the range of about 1 mm to about 10 mm inclusive.
10. The assembly of claim 8, wherein the single proximal waist
portions of the side and main balloon and the distal end portion of
the catheter shaft are bonded together with a heat bond
connection.
11. The assembly of claim 8, wherein an outer surface of the
proximal waist portion of the side balloon is disposed on an outer
surface of the proximal waist portion of the main balloon and the
distal end portion of the catheter shat is disposed inside the
proximal waist portion of the main balloon at the single location.
Description
RELATED APPLICATIONS
[0001] This application is a continuation of co-pending U.S.
application Ser. No. 12/183,869, filed Jul. 31, 2008, the entire
disclosure of which is incorporated herein by reference.
TECHNICAL FIELD
[0002] This disclosure relates to catheter systems and methods for
treating vessel bifurcations. This disclosure more particularly
relates to balloon bonding arrangements for bifurcation catheter
systems.
BACKGROUND
[0003] Catheters are used with stents and inflatable structures to
treat conditions such as strictures, stenoses, and narrowing in
various parts of the body. Various catheter designs have been
developed for the dilatation of stenoses and to deliver and deploy
stents at treatment sites within the body.
[0004] Stents are typically intraluminally placed by a catheter
within a vein, artery, or other tubular shaped body organ for
treating conditions such as, for example, occlusions, stenoses,
aneurysms, dissections, or weakened, diseased, or abnormally
dilated vessels or vessel walls, by expanding the vessels or by
reinforcing the vessel walls. Once delivered, the stents can be
expanded using one or more inflatable members such as balloons.
Stents can improve angioplasty results by preventing elastic recoil
and remodeling of the vessel wall and treating dissections in blood
vessel walls caused by balloon angioplasty of coronary arteries.
Stents can also be used as a drug delivery medium for treatment of
damaged portions of a vessel.
[0005] While conventional stent technology is relatively well
developed, stent technologies related to treatment of the region of
a vessel bifurcation are still being developed.
SUMMARY
[0006] The present disclosure relates generally to catheter
assemblies for treatment of bifurcated lumens in a patient, such as
vessel bifurcations. In one example, the catheter assembly includes
a main catheter branch and a side catheter branch. The main
catheter branch includes a catheter shaft having a distal end
portion. The catheter shaft defines a main inflation lumen. A main
balloon and a side balloon are positioned at the distal end portion
of the catheter shaft and in fluid communication with the main
inflation lumen. The main balloon includes a distal waist portion
at a distal end thereof, and a proximal waist portion at a proximal
end thereof. The side balloon includes an inflatable portion, a
proximal waist portion, and a distal waist portion, wherein the
proximal and distal waist portions define a side inflation lumen.
The inflatable portion of the side balloon is configured to extend
radially outward relative to the main balloon when the side balloon
is inflated. The proximal waist portion of the side balloon and the
proximal waist portion of the main balloon are secured to the
distal end portion of the catheter shaft at a single bond to create
a proximal balloon joint, wherein the main inflation lumen is in
fluid communication with the main balloon and the side inflation
lumen.
[0007] There is no requirement that an arrangement or method
include all features characterized herein to obtain some advantage
according to this disclosure.
DESCRIPTION OF THE DRAWINGS
[0008] FIG. 1 is a schematic representation of an exemplary
catheter assembly for treatment of a vessel bifurcation, the
assembly constructed having a proximal end portion and distal end
portion, wherein the distal end portion includes main and side
balloons and main and side catheter branches;
[0009] FIG. 2 is a schematic side view of the distal end portion of
the catheter assembly shown in FIG. 1 with the stent and side
catheter branch removed for clarity;
[0010] FIG. 3 is a schematic cross-sectional side view of the
distal end portion of the catheter assembly shown in FIG. 2;
[0011] FIG. 4 is a schematic enlarged view of the dual balloon
joint shown in FIG. 3;
[0012] FIG. 5 is a schematic enlarged view of the dual balloon
joint shown in FIG. 3 with mandrels inserted;
[0013] FIG. 6 is a schematic side view of the catheter assembly
shown in FIG. 1 in a position prepared for treatment of a vessel
bifurcation;
[0014] FIG. 7 is a schematic side view of the catheter assembly
shown in FIG. 6 with the side catheter branch extending into a
branch vessel of the vessel bifurcation;
[0015] FIG. 8 is a schematic side view of the catheter assembly
shown in FIG. 7 with the side and main balloons inflated and the
stent expanded at the vessel bifurcation;
[0016] FIG. 9 is a schematic cross-sectional side view of another
example catheter assembly having separate main balloon and side
balloon joints;
[0017] FIG. 10 is a schematic enlarged view of the side balloon
joint shown in FIG. 9; and
[0018] FIG. 11 is a schematic enlarged view of the main balloon
joint shown in FIG. 9.
DETAILED DESCRIPTION
[0019] This disclosure relates to bifurcation treatment systems,
catheter assemblies, and related methods of treating bifurcations
in a patient's body. The term bifurcation means a division location
from one unit into two or more units. Generally, two types of
bifurcations of a body organ include: 1) a main tubular member
defining a main lumen and a branch tubular member defining a branch
lumen that extends or branches off from the main tubular member,
wherein the main and branch lumens are in fluid communication with
each other, and 2) a primary or main member defining a primary or
main lumen (also referred to as a parent lumen) that splits into
first and second branch members defining first and second branch
lumens. The term lumen means the cavity or bore of a tubular
structure such as a tubular organ (e.g., a blood vessel).
[0020] An example bifurcation is a vessel bifurcation that includes
a continuous main vessel and a branch vessel, wherein the vessels
define a main lumen and a branch lumen, respectively that are in
fluid communication with each other. Alternatively, a vessel
bifurcation can include a parent vessel that divides into first and
second branch vessels, wherein the vessels define a parent lumen
and first and second branch lumens, respectively, which lumens are
all in fluid communication with each other.
[0021] Example applications of the inventive principles disclosed
herein include cardiac, coronary, renal, peripheral vascular,
gastrointestinal, pulmonary, urinary, and neurovascular systems.
The catheter assemblies, systems and methods disclosed herein can
be used for locating a branch vessel of the vessel bifurcation and
for placement of a stent relative to the vessel bifurcation for
treatment of the vessel bifurcation.
[0022] The example catheter assemblies disclosed herein include at
a distal end portion thereof a main catheter branch and a side
catheter branch. The side catheter branch typically includes a side
guidewire housing that defines a side guidewire lumen. A distal end
portion of the side catheter branch is configured to extend into a
branch vessel at a vessel bifurcation. The side catheter branch is
used to align features of a stent carried by the proximal end
portion of the vessel bifurcation treatment system with an ostium
(also referred to as a branch vessel opening) into the branch
vessel.
[0023] The main catheter branch includes a catheter shaft having a
distal end portion. A main balloon and a side balloon are
positioned at the distal end portion of the catheter shaft. A main
catheter branch includes a main guidewire housing that defines a
main guidewire lumen. A distal waist portion of the main balloon is
operably mounted to the main guidewire housing. A proximal waist
portion of the main balloon is operably mounted to the distal end
portion of the catheter shaft.
[0024] The side balloon is positioned on a side inflation member
that extends generally in parallel with the main balloon. The side
inflation member defines a side inflation lumen. The side inflation
member includes proximal and distal segments that are connected in
fluid communication with the side balloon. The distal and proximal
segments of the side inflation member can alternatively be
considered elongate waist portions of the side balloon that extend
in the distal and proximal directions, respectively.
[0025] The waist portion of a balloon is typically at one of the
opposing ends of the balloon. The waist portion is used to secure
or otherwise mount the balloon to a mounting surface, such as the
outer surface of a shaft. Some example mounting surfaces for the
waist portions of a main balloon are the outer surface of a distal
end portion of a catheter shaft and the outer surface of a main
guidewire housing. The waist portion is typically configured not to
expand in size when the balloon is inflated with inflation fluid.
In many instances a balloon is formed by molding from a length of
tubular structure (e.g., a catheter shaft comprising a
thermoplastic polymeric material). The portions of the tubular
structure extending on opposite sides of the molded balloon can be
considered waist portions of the balloon regardless of the length
of the waist portions.
[0026] Referring now to FIGS. 9-11, an example distal end portion
of a main catheter branch 112 is shown in cross-section. The main
catheter branch 12 includes a catheter shaft 20 having a distal end
portion 30 and a shaft distal segment 120 that together define a
main inflation lumen 32. A main guidewire housing 32 extends beyond
the distal end portion 30 of the catheter shaft. A main balloon 24
has a distal waist 36 at its distal end that is operably mounted to
the main guidewire housing 32. A proximal waist 38 at a proximal
end of the main balloon 24 is operably mounted to the shaft distal
segment 120 at a main balloon proximal joint 170.
[0027] A side balloon 26 is positioned adjacent to the main balloon
24. The side balloon 26 includes an inflatable portion 45, a distal
waist portion 44 extending from a distal side 40, and a proximal
waist portion 46 extending from a proximal side 42. The inflatable
portion 45 is positioned at a location between the distal and
proximal waists 36, 38 of the main balloon. The waist portions 44,
46 define a side inflation lumen 45 that provides fluid
communication from the main inflation lumen 32 to the side balloon
26. When inflated, the side balloon 26 extends radial outward
relative to the main balloon 24 (i.e., a longitudinal axis of the
main balloon 24). The distal and proximal waists 44, 46 can
alternatively be referenced as distal and proximal segments of a
side inflation member.
[0028] Typically, a distal end of the distal waist 44 is operably
mounted to the main guidewire member 22 distal of the main balloon
24, and the proximal end of the distal waist 44 is operably mounted
in fluid communication with the side balloon 26. A distal end of
the proximal waist 46 is operably mounted in fluid communication to
the side balloon 26, and a proximal end of the proximal waist 44 is
operably mounted to the distal end portion of the catheter shaft 20
in fluid communication with the main inflation lumen 32 at a side
balloon proximal joint 148. The side balloon proximal joint 148 is
spaced from a distal end of the shaft distal segment 120 a distal
L4, which is also the approximate length of shaft distal segment
120. The side balloon proximal joint 148 is also spaced from a
distal end of the proximal waist 38 of the main balloon 24 a
distance L5. The distance L4 is typically in the range of about 20
mm to about 50 mm.
[0029] A separate shaft distal segment 120 is typically used to
provide a joint between the proximal end of the distal segment 120
and the distal end of the shaft 30 at which the proximal waist 46
of the side balloon can be secured in fluid communication with the
main inflation lumen 32. In order to create fluid communication
with the proximal waist 46, the three components (proximal waist
46, distal segment 120 and catheter shaft 20) are bonded together
simultaneous using, for example, a heat bonding technique. Prior to
the simultaneous bonding, a first mandrel is inserted from the
catheter shaft 30 into the distal segment 120, and a second mandrel
is inserted from the catheter shaft 30 into the proximal waist 46.
In some arrangements, one or both of the catheter shaft 30 at a
distal end thereof and distal segment 120 at a proximal end thereof
has at least one slit formed therein to facilitate insertion of the
second mandrel from catheter shaft 30 into the proximal waist 46
while maintaining alignment and contact between the catheter shaft
30 and the distal segment 120. In one bonding method, heat is then
applied to the three components while the first and second mandrels
are in place to bond the three components to each other in fluid
communication. Other bonding techniques, such as adhesives and
laser welding, can be used to bond the three components together.
In separate bonding steps, the proximal waist 38 of the main
balloon 24 is bonded to the distal segment 120.
[0030] The use of a separate side balloon proximal joint 148 at a
location proximal of the main balloon proximal joint 170, and
positioning the proximal joint 148 a distance L5 from the proximal
end of the main balloon results in a number of potential
disadvantages. For example, the use of two separate joints and a
separate distal segment 120 of the catheter shaft proximal of the
main balloon 24 can result in additional stiffness in the main
catheter branch 112 that limits bending and rotation. Reducing
flexibility at the distal end of the main catheter branch 112 can
reduce incidence of self radial alignment of the side balloon and
features of a stent (e.g., stent 16 shown in FIG. 1) carried by the
main balloon 24 with an ostium of a branch vessel when treating a
vessel bifurcation (e.g., vessel bifurcation 80 shown in FIGS.
6-8). Another example disadvantage relates to the processes and
methods involved in manufacture of the main catheter branch 112.
Formation of each of the joints 148, 170 requires time and
additional steps. Each manufacturing step creates opportunity for
errors and must be monitored for quality. Reducing the number of
joints can reduce the overall time requirements for manufacture and
the number of steps in the manufacturing process, which can result
in reduced cost and improved consistency in manufacturing
processes. Reducing the number of joints in this case can also
eliminate an extra part from the assembly. If the side balloon
proximal joint 148 is combined with the main balloon proximal joint
170 as will be described below, the distal segment 120 can be
eliminated from the main catheter branch 112. Reducing the number
of parts can reduce the cost of the assembly and reduce the
complexity of the manufacturing process.
[0031] An example catheter assembly 10 is shown schematically with
reference to FIGS. 1-8. The catheter assembly 10 is configured for
treatment of a vessel bifurcation such as the vessel bifurcation 80
shown in FIGS. 6-8. The catheter assembly 10 includes a main
catheter branch 12, a side catheter branch 14, and a stent 16. The
main catheter branch 12 includes a catheter shaft 20 having a
proximal end portion 28 and a distal end portion 30. The catheter
shaft 20 further defines a main inflation lumen 32 (see FIG. 3).
The main catheter branch 12 further includes a main guidewire
housing 22. The main guide wire housing 22 defines a main guidewire
lumen 34 as shown in FIG. 3. The main catheter branch further
includes a main balloon 24 extending along the guidewire housing
22. A proximal waist 38 of the main balloon 24 is operably mounted
to the catheter shaft 20, and a distal waist of the main balloon 24
is operably mounted to the main guidewire housing 22.
[0032] The main catheter branch 12 further includes a side balloon
26. The side balloon 26 includes an inflatable portion 45, a waist
44, and proximal waist 46. The waist members 44, 46 define a side
inflation lumen 45 through which inflation fluid is provided to the
side balloon 26. The distal waist 44 has a length L2 in the range
of about 3 to about 15 mm, and more preferably about 6 to about 10
mm. The proximal waist 46 has a length L2 in the range of about 3
to about 15 mm, and more preferably about 6 to about 10 mm. The
side balloon includes front and rear sides 40, 42 from which the
distal and proximal waists 44, 46 extend. When uninflated, the
inflatable portion 45 of the side balloon 24 maintains a generally
collapsed profile (e.g., see side balloon 24 in the collapsed state
shown in FIGS. 1, 6 and 7). When inflated, the inflatable portion
of the side balloon 26 extends radially outward relative to the
longitudinal axis of the main balloon 24 (see FIGS. 2, 3 and
8).
[0033] Typically, a distal end of the distal waist 44 is operably
mounted to the main guidewire member 22 distal of the main balloon
24. The proximal end of the distal waist 44 is operably mounted in
fluid communication with the side balloon 26. A distal end of the
proximal waist 46 is operably mounted in fluid communication to the
side balloon 26. A proximal end of the proximal waist 44 is
operably mounted to the distal end portion of the catheter shaft 20
in fluid communication with the main inflation lumen 32 at a
proximal joint 48. The main balloon 24 is also coupled in fluid
communication with the inflation lumen 32 at the proximal joint 48
via the proximal waist 38 of the main balloon 24. The proximal
joint 48 is spaced from a distal end of the shaft distal segment
120 a distance L1. The distance L1 can be the approximate length of
the proximal waist 38 of the main balloon 24. The distance L4 is
typically in the range of about 1 mm to about 10 mm, and more
preferably in the range of about 2 mm to about 5 mm.
[0034] In order to create fluid communication between the main
inflation lumen 32 and side balloon 26, the proximal waist 46,
distal portion 30 of the catheter shaft 20, and main balloon
proximal waist 38 are bonded together simultaneously using, for
example, a heat bonding technique. Prior to the bonding, a first
mandrel 90 is inserted from the catheter shaft 30 into the side
balloon proximal waist 46, and a second mandrel 92 is inserted from
the catheter shaft 30 into the main balloon proximal waist 38 (see
FIG. 5). In some arrangements, one or both of the catheter shaft 20
and main balloon proximal waist 38 has at least one slit formed
therein to facilitate insertion of the second mandrel from catheter
shaft 30 into the proximal waist 46. In one bonding method, heat is
then applied to the proximal joint 48 while the first and second
mandrels are in place. The applied heat bonds the catheter shaft
20, the side balloon proximal waist 46, and main balloon proximal
waist 38 to each other in fluid communication.
[0035] Providing a proximal joint 48 wherein the side balloon 26
(via the proximal waist 46) and the main balloon 24 (via the
proximal waist 38) are bonded together at a single joint in fluid
communication with each other and the main inflation lumen 32
results in a number of potential advantages as compared to the two
proximal joint configuration of the main catheter branch 112. For
example, since bonding two or more members together (e.g., catheter
shaft 20 with a balloon waist of balloon 24 or 26) typically
results in a greater stiffness along the main catheter branch 12,
the use of a single proximal joint to bond both balloons 24, 26 to
the catheter shaft 20 can provide additional flexibility along the
distal portion of the main catheter branch 112. Increasing
flexibility at the distal portion of the main catheter branch 112
can improve the likelihood of self-radial alignment of the side
balloon and features of the stent 16 carried by the main balloon 24
with an ostium of a branch vessel when treating a vessel
bifurcation (e.g., vessel bifurcation 80 shown in FIGS. 6-8). As
the catheter assembly 10 is advanced over guidewires (e.g.,
guidewires 60, 62 described below) to the vessel bifurcation
treatment site, the distal end of the catheter assembly 10 can
become immobile in the vessel due to, for example, interference of
the assembly 10 with the vessel lumen or relative twist of the
guidewires, which inhibits advancement of the assembly 10 or proper
alignment with the ostium of the branch vessel. Providing some
rotational and bending flexibility in the main catheter branch 12
at the distal end portion 30 proximal of the balloons 24, 26 can
help the catheter assembly 10 become free from a bind and
self-radially align with the branch vessel ostium.
[0036] Another example advantage of the single proximal joint
arrangement of FIGS. 1-8 relates to the processes and methods
involved in manufacture of the main catheter branch 12.
Consolidating the proximal balloon joints to a single joint 48 can
reduce the overall time requirements for manufacture and simplify
the number of steps in the manufacturing process, which can results
in reduced cost and improved consistency in manufacturing processes
and quality. Reducing the number of proximal balloon joints can
also eliminate an extra part from the assembly, such as the shaft
distal segment 120. Reducing the number of parts can reduce the
cost of the assembly and reduce the complexity of the manufacturing
process.
[0037] The side balloon proximal waist 46 of the main catheter
branch 12 has a shorter length extending proximal of a proximal end
of the stent 16 as compared to the arrangement of main catheter
branch 112. The shorted portion of the proximal waist 46 that
extends proximal of the proximal end of the stent 16 in main
catheter branch 12 is less susceptible to snagging or otherwise
catching on objects prior to and during advancement of the main
branch 12 through a body lumen to a bifurcation treatment site, and
the subsequent removal of the main branch 12 from the body.
Further, the shorter distance between the proximal joint 48 and the
connection point of the distal waist 44 to the guidewire housing 22
distal of the main balloon reduces the likelihood of misalignment
of the side balloon 26 with features of the stent (e.g., the stent
lateral branch opening) and the ostium of a branch vessel prior to
and during expansion of the stent 16 when treating the vessel
bifurcation.
[0038] These and other advantages can results from the single
proximal balloon joint or bond shown and described herein. The
single proximal balloon joint or bond can also be referred to as a
dual balloon bond, since it involves bonding two balloons (via
balloon waists 38 and 46) in fluid communication with the main
inflation lumen 32 at a single bond or joint location using a
single bonding process.
[0039] The catheter assembly 10 described above with reference to
FIGS. 1-6 can be used for treatment of a vessel bifurcation 80 as
shown in FIGS. 6-8. Typically, a main vessel guidewire 62 is
inserted into a main vessel 82 of the vessel bifurcation 80 to a
point distal of the vessel bifurcation. A branch vessel guidewire
60 is advanced to the vessel bifurcation and inserted through an
ostium or opening 86 of a branch vessel 84. A proximal end of the
main vessel guidewire 62 is then inserted into the main guidewire
lumen 34, and a proximal end of the branch vessel guidewire 60 is
inserted into a branch guidewire lumen defined by the side catheter
branch 14. The catheter assembly 10 is advanced over the guidewires
60, 62 to the vessel bifurcation as shown in FIG. 6. The catheter
assembly 10 is then advanced further distally until the distal end
portion 56 of the side catheter branch 14 is positioned within the
branch vessel 60. A marker system can be used to help confirm
proper radial and axial alignment of the lateral branch opening 54
of the stent 16 relative to the ostium 86 into the branch vessel
84. An example four-marker system is described below.
[0040] As mentioned above, the increased flexibility of the distal
portion of the main catheter branch 12 resulting from the single
proximal balloon bond 48 can promote improved self-radial alignment
of the side balloon 26 and lateral branch opening 54 of the stent
16 relative to the ostium 86. The single proximal balloon bond 48,
which is positioned at the distal most location along the catheter
shaft 20, provides for maximum twist per unit length in the area X
at the distal end portion 30 (see FIG. 2), wherein the area X
represents the area in which the two proximal balloon bonds of main
catheter branch 112 typically exist.
[0041] After proper positioning of the catheter assembly 10 is
confirmed, the main and branch balloons 24, 26 are inflated.
Typically, inflation of the side balloon 26 can also result in
expansion of expandable structure 55 surrounding the lateral branch
opening 54. The expanded expandable structure 55 can extend through
the ostium 86 and at least partially into the branch vessel 84.
[0042] In a follow-up step, after the balloons 24, 26 have been
deflated and the catheter branches 12, 14 removed, a separate
balloon member can be advanced through the lateral branch opening
to treat the branch vessel 84 and further open the expandable
structure 55 into the branch vessel 84. In a still further step, an
additional branch stent can be advanced through the lateral branch
opening 55 and into the branch vessel 84 for treatment of the
branch vessel 84.
[0043] The particular method steps described above can be altered
in other example treatment methods. For example, one of the
guidewires 60, 62 can be advanced with the catheter assembly 10 to
the vessel bifurcation. In another example, the balloons 24, 26 can
be inflated sequentially rather than simultaneously for purposes
of, for example, improving alignment of the lateral branch opening
55 with the ostium into the branch vessel.
[0044] The catheter assembly 10 can include marker material that is
visible under X-ray or in fluoroscopy procedures. FIG. 6
illustrates markers 1-4 positioned along the distal end portions of
the main and side catheter branches 12, 14. Any features of the
system 10 that include marker material can be more easily
identified and distinguished under X-ray or in fluoroscopy
procedures. Some example marker materials include gold, platinum
and tungsten. In one embodiment, the marker material can be
included in a band structure that is secured to at least one of the
main and side catheter branches 12, 14. In other embodiments, the
marker material is part of the material composition of portions of
the main and side catheter branches 12, 14. Viewability of features
of the catheter assembly 10 under X-ray or fluoroscopy can assist
the physician operating the system 10 to more easily adjust a
position of the system 10 relative to the vessel bifurcation 80.
Example markers and marker materials suitable for use with system
10 are described in U.S. Pat. No. 6,692,483 to Vardi, et al, and
co-pending U.S. Patent Publication No. 2007/0203562-A1, titled
MARKER ARRANGEMENT FOR BIFURCATION CATHETER, which patent matters
are incorporated herein by reference.
[0045] A wide variety of stents, catheters, and guidewire
configurations can be used with the catheter assembly embodiments
of the present disclosure. The inventive principles disclosed
herein should not be limited to any particular design or
configuration. Some example stents that can be used with the
catheter assemblies disclosed herein can be found in, for example,
U.S. Pat. Nos. 6,210,429; 6,325,826; 6,706,062; and 7,220,275, and
U.S. Published Patent Application No. 2004/0176837 titled
SELF-EXPANDING STENT AND CATHETER ASSEMBLY AND METHOD FOR TREATING
BIFURCATIONS, the entire contents of which are incorporated herein
by reference. In general, the aforementioned stents include a
lateral branch opening located between distal and proximal open
ends of the stent. The lateral branch opening defines a path
between an inner lumen of the stent and an area outside of the
stent. The stent lateral branch opening is distinct from the cell
openings defined between strut structures from which the stent
sidewall is constructed. In some stents, the lateral branch opening
can be surrounded by expandable structure. The expandable structure
can be configured to extend radially into the branch lumen of the
bifurcation upon expansion of, for example, an inflatable portion
of the bifurcation treatment system. Typically, the stent is
expanded after being positioned in the main lumen with the lateral
branch opening aligned with an opening into the branch lumen.
Alignment of the lateral branch opening with the opening into the
branch lumen includes both radial and axial alignment. The stent,
including the expandable structure surrounding the lateral branch
opening, can be expanded with a single expansion or multiple
expansions using one or more inflatable members.
[0046] The main and side balloons, and all other balloons disclosed
herein, can be made of any suitable balloon material including
compliant and non-compliant materials and combinations thereof.
Some example materials for the balloons and catheters disclosed
herein include thermoplastic polymers, polyethylene (high density,
low density, intermediate density, linear low density), various
co-polymers and blends of polyethylene, ionomers, polyesters,
polycarbonates, polyamides, poly-vinyl chloride,
acrylonitrile-butadiene-styrene copolymers, polyether-polyester
copolymers, and polyetherpolyamide copolymers. One suitable
material is Surlyn.RTM., a copolymer polyolefin material (DuPont de
Nemours, Wilmington, Del.). Still further suitable materials
include thermoplastic polymers and thermoset polymeric materials,
poly(ethylene terephthalate) (commonly referred to as PET),
thermoplastic polyamide, polyphenylene sulfides, polypropylene.
Some other example materials include polyurethanes and block
copolymers, such as polyamide-polyether block copolymers or
amide-tetramethylene glycol copolymers. Additional examples include
the PEBAX.RTM. (a polyamide/polyether/polyester block copolymer)
family of polymers, e.g., PEBAX.RTM. 70D, 72D, 2533, 5533, 6333,
7033, or 7233 (available from Elf AtoChem, Philadelphia, Pa.).
Other examples include nylons, such as aliphatic nylons, for
example, Vestamid.RTM. L21011F, Nylon 11 (Elf Atochem), Nylon 6
(Allied Signal), Nylon 6/10 (BASF), Nylon 6/12 (Ashley Polymers),
or Nylon 12. Additional examples of nylons include aromatic nylons,
such as Grivory.RTM. (EMS) and Nylon MXD-6. Other nylons and/or
combinations of nylons can also be used. Still further examples
include polybutylene terephthalate (PBT), such as CELANEX.degree.
(available from Ticona, Summit, N.J.), polyester/ether block
copolymers such as ARNITEL.RTM. (available from DSM, Erionspilla,
Ind.), e.g., ARNITEL.RTM. EM740, aromatic amides such as
Trogamid.RTM. (PA6-3-T, Degussa), and thermoplastic elastomers such
as HYTREL.RTM. (Dupont de Nemours, Wilmington, Del). In some
embodiments, the PEBAX.RTM., HYTREL.RTM., and ARNITEL.RTM.
materials have a Shore D hardness of about 45D to about 82D. The
balloon materials can be used pure or as blends. For example, a
blend may include a PBT and one or more PBT thermoplastic
elastomers, such as RITEFLEX.RTM. (available from Ticona),
ARNITEL.RTM. or HYTREL.RTM., or polyethylene terephthalate (PET)
and a thermoplastic elastomer, such as a PBT thermoplastic
elastomer. Additional examples of balloon material can be found in
U.S. Pat. No. 6,146,356, which is incorporated herein by
reference.
[0047] One aspect of the present disclosure relates to catheter
assembly that includes a main catheter branch and a side catheter
branch. The main catheter branch includes a catheter shaft, a main
balloon, and a side balloon. The catheter shaft has a proximal end
portion and a distal end portion, wherein the distal end portion
defines a main inflation member. The main balloon has a distal
waist at a distal end portion thereof and a proximal waist portion
at a proximal end portion thereof. The side balloon has an
inflatable portion, a distal waist at a distal end portion thereof,
and a proximal waist portion at a proximal end portion thereof. The
side balloon is configured to extend in a radial direction relative
to the main balloon when the side balloon is inflated, the
inflatable portion positioned at a location between the proximal
and distal end portions of the main balloon, the proximal waist of
the side balloon and the proximal waist of the main balloon
operatively mounted in fluid communication to the main inflation
lumen shaft at a proximal balloon joint positioned at the distal
end portion of the catheter shaft.
[0048] Another aspect of the present disclosure relates to a
catheter assembly that includes a main catheter branch, a side
catheter branch, and a stent. The main catheter branch has a
proximal end portion and a distal end portion. The distal end
portion includes a catheter shaft, a main guidewire housing, and a
main balloon. The catheter shaft has a distal end portion and
defines a main inflation lumen. The main guidewire housing extends
distally beyond the distal end portion of the catheter shaft and
defines a main guidewire lumen. The main balloon has a proximal
waist portion and a distal waist portion. The side balloon has an
inflatable portion, a proximal waist portion, and a distal waist
portion. The proximal and distal waist portions of the side balloon
define a side inflation lumen, and the proximal waist portion of
the side balloon and the proximal waist portion of the main balloon
are operably mounted in fluid communication with the main inflation
lumen at a proximal balloon joint. The side catheter branch has a
distal end portion, and the side catheter branch defines a side
guidewire lumen. The stent has proximal and distal open ends and a
lateral branch opening defined in the stent at a location between
the proximal and distal open ends. The distal end portion of the
side catheter branch extends through the lateral branch opening
prior to inflation of the main balloon and the side balloon.
[0049] A further aspect of the present disclosure relates to a
method of manufacturing a catheter assembly. The catheter assembly
includes a main catheter branch having a catheter shaft, a main
balloon, and a side balloon. The catheter shaft has a distal end
portion and defines a main inflation lumen. The main balloon has a
proximal waist at a proximal end portion thereof and a distal waist
at a distal end portion thereof. The side balloon has an inflatable
portion and a proximal waist portion extending proximally from the
inflatable portion. The inflatable portion is positioned at a
location between the proximal and distal waists of the main
balloon. The inflatable portion extends radially relative to the
main balloon when the side balloon is inflated. The method includes
positioning a proximal open end of the side balloon proximal waist
and a proximal open end of the main balloon proximal waist adjacent
to each other and in fluid communication with the main inflation
lumen at the distal end portion of the catheter shaft, and securing
the side balloon proximal waist, the main balloon proximal waist,
and the distal end portion of the catheter shaft together a
proximal balloon joint while maintaining fluid communication
between the side balloon proximal waist, the main balloon proximal
waist, and the main inflation lumen.
[0050] It is noted that not all of the features characterized
herein need to be incorporated within a given arrangement, for the
arrangement to include improvements according to the present
disclosure.
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