| Apparatus for delivering endoluminal prostheses and methods of making and using them -> Monitor Keywords |
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Apparatus for delivering endoluminal prostheses and methods of making and using themRelated Patent Categories: Prosthesis (i.e., Artificial Body Members), Parts Thereof, Or Aids And Accessories Therefor, Arterial Prosthesis (i.e., Blood Vessel), Stent Combined With Surgical Delivery System (e.g., Surgical Tools, Delivery Sheath, Etc.)Apparatus for delivering endoluminal prostheses and methods of making and using them description/claimsThe Patent Description & Claims data below is from USPTO Patent Application 20050283222, Apparatus for delivering endoluminal prostheses and methods of making and using them. Brief Patent Description - Full Patent Description - Patent Application Claims [0001] This application is a continuation of application Ser. No. 09/664,970, filed Sep. 18, 2000, the disclosures of which is expressly incorporated herein by reference. FIELD OF THE INVENTION [0002] The present invention relates generally to apparatus and methods for delivering endoluminal prostheses within body lumens of a patient, and more particularly to apparatus for delivering tubular prostheses or "stents" within a patient's vasculature for treating stenoses or other lesions, for example, within the coronary and carotid arteries, and to methods of making and using such apparatus. BACKGROUND [0003] In recent years, a number of minimally invasive technologies have been developed for treating diseases, such as atherosclerosis, that result in narrowing of blood vessels, for example, within the coronary or carotid arteries. Tubular prostheses or "stents" have been developed for maintaining the patency of a blood vessel, for example, following angioplasty or other procedures used to treat a stenosis, occlusion, or other lesion within the blood vessel. The stent may be implanted across a treatment site to scaffold the site and prevent it from subsequently contracting or otherwise becoming obstructed. [0004] Generally, the stent may be placed upon a catheter in a contracted condition, and the catheter advanced endoluminally to the treatment site until the stent is positioned across the stenosis. The stent may then be deployed and substantially anchored at the treatment site. The stent may be self-expanding, i.e., may be biased to expand to an enlarged condition upon release from the delivery catheter, thereby automatically substantially anchoring the stent at the treatment site. Alternatively, the stent may be plastically deformable, i.e., may be expanded with the aid of a balloon, which may underlie the stent on the catheter. The balloon may be inflated to expand the stent from the contracted condition to the enlarged condition wherein the stent substantially engages the wall of the treatment site. A balloon, for example, on a separate balloon catheter, may also be used to further expand and/or anchor a self-expanding stent. [0005] Similarly, for ablation procedures and the like, a catheter including an array of electrodes, for example, on an expandable basket assembly, may be provided. The device may be introduced into a body lumen, e.g., through the patient's vasculature into the heart, to treat conditions, such as heart arrhythmia. [0006] With any of these devices, a sheath may be provided over the catheter to protect the elements on the distal end of the catheter, such as a stent, a balloon, and/or an array of electrodes. The sheath may be advanced distally over the proximal end of the catheter until it covers the distal end and the element(s) thereon, or the distal end of the catheter may be introduced into the sheath, and advanced until it is proximate the distal end of the sheath. The distal end of the catheter, with the overlying sheath thereon, may then be introduced into a patient and positioned at a treatment site, whereupon the sheath may be retracted to expose the distal end of the catheter. After treatment, the sheath may be advanced back over the distal end of the catheter, and the entire device withdrawn from the patient. [0007] One of the problems associated with these devices is that they may have substantially blunt distal ends that may scrape along the wall of a vessel during advancement therethrough, possibly damaging the wall and/or dislodging embolic material from the wall. To facilitate atraumatic advancement, particularly through tortuous anatomy, transition tips have been suggested for these devices. [0008] For example, a conical or tapered nosepiece may be provided on the distal end of the catheter. A sheath may be disposed over the catheter, for example, to substantially cover the stent or other underlying element, such that the nosepiece extends distally from the end of the sheath, a distal edge of the sheath abutting the nosepiece. The nosepiece may facilitate advancement of the device through a narrow region of a blood vessel, although it may also risk catching on the wall of the vessel and/or dislodging embolic material, e.g., between the distal edge of the sheath and the nosepiece. Following delivery of a stent from the device, the nosepiece is generally positioned distal to the treated lesion. If the nosepiece is withdrawn directly, the proximal edge of the nosepiece may catch on the stent struts, resulting in the potential for trauma and embolic debris release. Alternatively, the sheath may be re-advanced across the treatment site to "recapture" the nosepiece, although in this approach the distal edge of the sheath may also catch on the stent struts. [0009] As an alternative to a tapered nosepiece, a sheath having a rounded distal end has been suggested, as disclosed in U.S. Pat. No. 5,593,412 issued to Martinez et al. Weakened areas or slits are provided in the distal end, thereby defining sections that may be softened upon introduction of warm saline solution. Once the sections are softened, the sheath may be retracted from an underlying balloon catheter to expose and implant a stent mounted on the catheter. Introduction of saline or other liquids into a patient's vasculature, however, may be undesirable, but is necessary in order to soften the sections on the distal end of the sheath and allow the stent to be deployed from the sheath. [0010] Another problem associated with such delivery systems is that the sheaths and/or catheters may buckle during insertion, because of the distal force applied from the proximal end to advance them through the patient's vasculature. In addition, because of their tubular nature, they may kink when advanced through tortuous anatomy, possibly damaging the device or an element within the device. [0011] Accordingly, it is believed that delivery systems that facilitate delivery of a stent through a patient's vasculature and/or that overcome the problems discussed above would be considered useful. SUMMARY OF THE INVENTION [0012] The present invention is directed to apparatus for delivering treatment elements, such as tubular prostheses or "stents," within a body lumen of a patient, for example, for treating stenoses or other lesions within the coronary arteries, the carotid arteries, or other blood vessels, and to methods of making and using such apparatus. [0013] In accordance with one aspect of the present invention, an apparatus is provided for delivering a prosthesis into a blood vessel of a patient that includes an elongate tubular member having a proximal end, a distal end, and a lumen extending between the proximal and distal ends. The distal end has a size for endoluminal insertion into a blood vessel and terminates in a substantially atraumatic distal portion including a plurality of flexible leaflets integrally molded thereto. [0014] The leaflets are deflectable from a closed position wherein the leaflets engage one another to an open position wherein the leaflets define an opening communicating with the lumen. Preferably, the leaflets define a substantially rounded bullet shape in the closed position, although alternatively, the leaflets may define a substantially conical shape in the closed position. The leaflets are preferably substantially flexible and independently deflectable at a temperature less than body temperature, and are biased towards the closed position, but are resiliently deflectable to the open position. Adjacent leaflets may be separated by a slit, or may be connected to one another by weakened regions, the weakened regions being tearable upon retraction of the tubular member with respect to the prosthesis to allow the leaflets to be deflected towards the open position. [0015] In a preferred embodiment, a tubular prosthesis is disposed within the lumen proximate the distal portion. An elongate bumper member having a proximal end and a distal end is also provided, the bumper member being slidably disposed within the lumen of the sheath. The distal end of the bumper member has a blunt edge disposed adjacent to the proximal end of the prosthesis for preventing axial displacement of the prosthesis upon retraction of the tubular member with respect to the bumper member and/or the prosthesis. [0016] Preferably, the prosthesis comprises a self-expanding stent, such as a coiled-sheet stent, the stent being biased to assume an expanded condition having a cross-section larger than the lumen of the tubular member, and being compressible to a contracted condition to facilitate insertion into the lumen. [0017] In accordance with another aspect of the present invention, an apparatus for delivering a prosthesis into a blood vessel of a patient is provided that includes an elongate tubular member, such as that described above, having a proximal end, a distal end, and a lumen extending between the proximal and distal ends, the distal end having a size for endoluminal insertion into a blood vessel. A tubular prosthesis is disposed within the lumen proximate the distal end. An elongate bumper member is also provided that includes a helical coil having a proximal end and a distal end, the bumper member being slidably disposed within the lumen of the sheath. The distal end of the bumper member has a blunt distal edge disposed adjacent a proximal end of the prosthesis for preventing axial displacement of the prosthesis upon retraction of the tubular member with respect to the bumper member. [0018] In a preferred embodiment, the bumper member includes a helical wire compression coil, preferably a solid height coil, extending between its proximal and distal ends. A plastic bumper element extends from a distal end of the helical coil, the bumper element including the blunt distal edge thereon. An extension element extends distally from the bumper element, the extension element having a cross-section substantially smaller than the bumper element, whereby the extension element may extend through the prosthesis disposed within the lumen of the tubular member. The helical coil, bumper element, and/or the extension element include a lumen extending axially therethrough for receiving a guidewire therethrough. [0019] In accordance with yet another aspect of the present invention, a method for making a sheath for delivering a treatment element within a body lumen of a patient is provided. A tubular member is provided that is formed from a substantially flexible material, the tubular member having a proximal end, a distal end, and a lumen extending axially between the proximal and distal ends, the distal end having a size for endoluminal insertion into a body lumen. A die is provided having a bore therein, the bore having a tapered shape. The die is heated to a temperature in excess of a melting point of the flexible material from which the tubular member is formed. The distal end of the tubular member is inserted into the bore of the heated die until a distal portion of the tubular member is softened and deformed into a tapered shape substantially enclosing the distal end. One or more slits are then created in the distal portion of the tubular member after it is deformed into the tapered shape, the slits defining a plurality of leaflets. A treatment element may be inserted into the lumen of the tubular member until it is disposed proximate the distal portion. [0020] In a preferred method, a bullet having a tapered shape distal end is inserted into the distal end of the tubular member before inserting the distal end of the tubular member into the bore. Preferably, the bullet and the bore have corresponding substantially rounded shapes defining a mold cavity therebetween when the distal end of the tubular member is inserted into the bore. [0021] In another preferred method, the treatment element is a tubular prosthesis for implantation within a body lumen of a patient. Preferably, the prosthesis is a self-expanding stent biased to assume an expanded condition having a cross-section larger than the lumen, and compressible to a contracted condition before being inserted into the lumen of the tubular member. The prosthesis may be inserted into the lumen of the tubular member before inserting the distal end of the tubular member into the bore, e.g., inserted into the lumen from the distal end of the tubular member. Alternatively, the prosthesis may be inserted into the lumen from the proximal end of the tubular member, e.g., either before or after the leaflets are formed on the distal portion of the tubular member. 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