EP0904745A2
Expired / Lapsed
EP
⏱️ 0.0 years remaining
Endolumenal prosthesis and method of use in bifurcation regions of body lumens
Assignee: Medtronic Vascular Inc
•
Filing: 1998-09-11
•
Granted: —
•
Expires: 2018-09-11
Abstract
Abstract An endolumenal medical device assembly (1) is provided for use in a bifurcation region of a body lumen. An expandable prosthesis (10), preferably an endolumenal support device such as a stent, is included in the assembly and is adjustable from a radially collapsed condition to a radially expanded condition. The expandable prosthesis further includes a prosthesis passageway (16) and a side port (19) through which the prosthesis passageway communicates externally of the prosthesis. A dilator or an access device (20, 21) is engaged within the prosthesis passageway (16) and also through the side port while the expandable prosthesis is in the radially collapsed condition. By coupling a guidewire (40) to an access device engaged within the side port and positioning the guidewire therein, the expandable prosthesis may be positioned in the bifurcation region (105) such that its distal end portion is in a first branch lumen (112) extending from the bifurcation, its proximal end portion is in a common proximal lumen (110) of the bifurcation region, and the side port (19) is aligned with an entrance zone to a second branch lumen (114) extending from the bifurcation. When the expandable prosthesis is positioned at the bifurcation region (105) in this orientation, the access device maintains percutaneous translumenal access to the second branch lumen through the prosthesis passageway and the side port while the expandable prosthesis is adjusted from the radially collapsed condition to the radially expanded condition. In addition, a dilator (30) when engaged within the side port (19) is adapted to expand the bore formed by the side port from an initial inner diameter to a larger expanded inner diameter. A second, lateral expandable prosthesis (31) can also be coupled to the first expandable prosthesis at a location adjacent to the side port such that the dilator or access device extending through the side port is engaged within a lateral prosthesis lumen extending through the lateral expandable prosthesis.
Inventors
- 👤 Antonio Colombo
- 👤 Robert D. Lashinski
- 👤 Matthew J. Birdsall
- 👤 Dennis L. Brooks
- 👤 Philip J. Haarstad
- 👤 James C. Peacock, Iii
Bibliographic Details
Application Number
—
Jurisdiction
EP
Data Source
google_patents
Last Synchronized
2026-10-23 11:25
CPC Classifications
A; A61; A61F; A61F2/00; A61F2/82; A61F2/856; A61F2/86; A61F2/90; A61F2/91; A61F2/915; A61F2/95; A61F2/954; A61F2/958; A61F2/02; A61F2/04; A61F2/06; A61F2002/065; A61F2002/91533; A61F2002/91541; A61F2002/9155; A61F2002/91558; A61F2250/00; A61F2250/0014; A61F2250/0039
Claims Analysis
Total Claims: 55
Claim 1
Independent Claim
353 words
An endolumenal medical device assembly for engaging an
interior surface of a body lumen wall at a bifurcation region of a body lumen,
the bifurcation region including at least a first and a second branch lumen each
having an entrance zone extending from a common branch lumen, comprising: an expandable prosthesis having an elongate prosthesis body with a
proximal end portion, a distal end portion, a length along a longitudinal axis
extending between the proximal and distal end portions, a prosthesis
passageway which extends along the length, and a side port which is positioned
along the length and through which the prosthesis passageway communicates
externally of the elongate prosthesis body, the expandable prosthesis further
being adjustable from a radially collapsed condition, wherein the elongate
prosthesis body has a collapsed outer diameter, to a radially expanded
condition, wherein the elongate prosthesis body has an expanded outer
diameter which is larger than the collapsed outer diameter; a delivery member having a proximal end portion and a distal end
portion which is coupled to the expandable prosthesis, the delivery member
being adapted to deliver the expandable prosthesis to the bifurcation region in a
percutaneous translumenal procedure by manipulating the proximal end portion
of the delivery member; an expansion member with a proximal end portion and a distal end
portion which is removably engaged with the elongate prosthesis body, the
distal end portion of the expansion member further being adapted to adjust the
expandable prosthesis from the radially collapsed condition to the radially
expanded condition when the elongate prosthesis body is engaged with the
expansion member and is positioned at the bifurcation region; and a dilator with a proximal end portion and a distal end portion which is
engaged within the prosthesis passageway and also within the side port when
the expandable prosthesis is in the radially collapsed condition, wherein the
distal end portion of the dilator is adjustable from a first dilator position,
wherein the side port has an initial inner diameter, to a second dilator position,
wherein the side port is dilated to an expanded inner diameter which is larger
than the initial inner diameter.
Claim 2
Dependent Claim
31 words
The endolumenal medical device assembly of claim 1, wherein
the expanded inner diameter approximates an inner lumenal diameter at the
entrance zone of one of the first and second branch lumens.
Claim 3
Dependent Claim
22 words
The endolumenal medical device assembly of claim 1, wherein
the expanded inner diameter is within the range of 1.0 to 5.0 millimeters.
Claim 4
Dependent Claim
134 words
The endolumenal medical device assembly of claim 1, wherein
the dilator further comprises: a dilator inflation lumen extending between the proximal and distal end
portions of the dilator, the distal end portion of the dilator further including an
expandable balloon which is fluidly coupled to the dilator inflation lumen and
which is also engaged within the side port, the proximal end portion of the
dilator further including a fluid coupler which is in fluid communication with
the dilator inflation lumen and which is adapted to couple with a pressurizeable
fluid source, whereby coupling a pressurizeable fluid source to the fluid coupler and
pressurizing the expandable balloon with fluid, the expandable balloon may be
expanded from an unexpanded condition, which characterizes the first dilator
position, to an expanded condition, which characterizes the second dilator
position.
Claim 5
Dependent Claim
64 words
The endolumenal medical device assembly of claim 4, wherein
the dilator further comprises: a guidewire with a proximal end portion and a distal end portion which
is coupled to at least the distal end portion of the dilator, the distal end portion
of the guidewire further including a shaped, radiopaque tip region which is
steerable by torquing the proximal end portion of the guidewire.
Claim 6
Dependent Claim
94 words
The endolumenal medical device assembly of claim 4, wherein
the dilator further comprises: a guidewire tracking member extending at least along the distal end
portion of the dilator, the guidewire tracking member further including a
guidewire lumen which extends between a distal guidewire port located along
the guidewire tracking member distally of the expandable balloon and a
proximal guidewire port located along the guidewire tracking member
proximally of the prosthesis passageway, the guidewire tracking member being
adapted to track a guidewire slideably received within the guidewire lumen
through the proximal and distal guidewire ports.
Claim 7
Dependent Claim
66 words
The endolumenal medical device assembly of claim 6, further
comprising: a guidewire which has a proximal end portion and a distal end portion
with a shaped, radiopaque tip region which is steerable by torquing the
proximal end portion of the guidewire, the distal end portion of the guidewire
further being adapted to slideably engage within the guidewire lumen and
through the proximal and distal guidewire ports.
Claim 8
Dependent Claim
66 words
The endolumenal medical device assembly of claim 1, wherein
the dilator further comprises: a taper having a distally reducing outer diameter from a large outer
diameter portion to a small outer diameter portion, wherein the first dilator
position the small outer diameter portion is engaged within the side port, and in
the second dilator position the large outer diameter portion is engaged within
the side port.
Claim 9
Dependent Claim
45 words
The endolumenal medical device assembly of claim 1, wherein
the expandable prosthesis further comprises an endolumenal stent which is
adapted to provide radial support to the body lumen wall when the expandable
prosthesis is expanded from the radially collapsed condition to the radially
expanded condition.
Claim 10
Dependent Claim
59 words
The endolumenal medical device assembly of claim 9, wherein
the endolumenal stent comprises a tubular stent wall which is formed by a
plurality of integrated support members, the tubular stent wall further including
a plurality of gaps formed between portions of the integrated support members,
the side port being formed at least in part by one of the gaps.
Claim 11
Dependent Claim
98 words
The endolumenal medical device assembly of claim 1, wherein
the expandable prosthesis is balloon expandable, and wherein the expansion
member further comprises an inflation lumen extending between the proximal
and distal end portions of the expansion member, the distal end portion of the
expansion member further including an expandable balloon which is fluidly
coupled to the inflation lumen and which is engaged within the prosthesis
passageway, the proximal end portion of the expansion member further
including a fluid coupler which is fluidly coupled to the inflation lumen and
which is adapted to couple to a pressurizeable fluid source.
Claim 12
Dependent Claim
63 words
The endolumenal medical device assembly of claim 1, wherein
the expandable prosthesis is self-expandable from an elastically deformed
condition in the radially collapsed condition to a resting condition in the
radially expanded condition, and wherein the expandable prosthesis is radially
constrained in the radially collapsed condition by the expansion member and is
radially unconstrained by the expansion member in the radially expanded
condition.
Claim 13
Dependent Claim
77 words
The endolumenal medical device assembly of claim 12, wherein
the expansion member further comprises a sheath which forms a sheath lumen
and which is adjustable from a constraining position, wherein the expandable
prosthesis is coaxially confined and constrained in the radially collapsed
condition within the sheath lumen, to a releasing position, wherein the
expandable prosthesis is released from within the sheath lumen and is radially
unconfined and self-expands to the resting condition in the radially expanded
condition.
Claim 14
Dependent Claim
187 words
The endolumenal medical device assembly of claim 1, further
comprising: a lateral expandable prosthesis having a lateral elongate prosthesis body
with a proximal end portion, a distal end portion, and a lateral prosthesis
lumen extending between a proximal end port located along the proximal end
portion of the lateral elongate prosthesis body and a distal end port located
along the distal end portion of the lateral elongate prosthesis body, the lateral expandable prosthesis being adjustable from a second radially
collapsed condition, wherein the lateral elongate prosthesis body has a second
collapsed outer diameter, to a second radially expanded condition, wherein the
lateral elongate prosthesis body has a second expanded outer diameter, the proximal end portion of the lateral elongate prosthesis body being
coupled to the elongate prosthesis body at a location adjacent to the side port,
and wherein the distal end portion of the dilator is engaged within the lateral
prosthesis lumen such that when the dilator is adjusted from the first dilator
position to the second dilator position the lateral expandable prosthesis is
expanded from the second radially collapsed condition to the second radially
expanded condition.
Claim 15
Dependent Claim
141 words
The endolumenal medical device assembly of claim 14, wherein
the dilator further comprises: a dilator inflation lumen extending between the proximal and distal end
portions of the dilator, the distal end portion of the dilator further including an
expandable balloon which is fluidly coupled to the dilator inflation lumen and
which is also engaged within the side port and also within the lateral prosthesis
lumen, the proximal end portion of the dilator further including a fluid coupler
which is in fluid communication with the dilator inflation lumen and which is
adapted to couple with a pressurizeable fluid source, whereby coupling a pressurizeable fluid source to the fluid coupler and
pressurizing the expandable balloon with fluid, the expandable balloon may be
inflated from a non-expanded condition, which characterizes the first dilator
position, to an expanded condition, which characterizes the second dilator
position.
Claim 16
Dependent Claim
49 words
The endolumenal medical device assembly of claim 14, wherein
the expanded inner diameter and the second expanded outer diameter are each
within the range of 1.0 to 5.0 millimeters when the distal end portion of the
dilator is adjusted from the first dilator position to the second dilator position.
Claim 17
Dependent Claim
386 words
An endolumenal medical device assembly for engaging an
interior surface of a body lumen wall at a bifurcation region of a body lumen,
the bifurcation region including at least first and second branch lumens each
having an entrance zone extending from a common branch lumen, comprising: an expandable prosthesis having an elongate prosthesis body with a
proximal end portion, a distal end portion, a length along a longitudinal axis
extending between the proximal and distal end portions, a prosthesis
passageway which extends along the length, and a side port which is positioned
along the length and through which the prosthesis passageway communicates
externally of the elongate prosthesis body, the expandable prosthesis further
being adjustable from a radially collapsed condition, wherein the elongate
prosthesis body has a collapsed outer diameter, to a radially expanded
condition, wherein the elongate prosthesis body has an expanded outer
diameter which is larger than the collapsed outer diameter; a delivery member having a proximal end portion and a distal end
portion which is coupled to the expandable prosthesis, the delivery member
further being adapted to deliver the expandable prosthesis to the bifurcation
region in a percutaneous translumenal procedure by manipulating the proximal
end portion of the delivery member; an expansion member with a proximal end portion and a distal end
portion which is removably engaged with the elongate prosthesis body, the
distal end portion of the expansion member further being adapted to actuate
radial expansion of the expandable prosthesis from the radially collapsed
condition to the radially expanded condition when the elongate prosthesis body
is engaged with the expansion member and is positioned at the bifurcation
region; and an access device with a proximal end portion and a distal end portion,
the distal end portion of the access device being engaged within the prosthesis
passageway at least along the proximal end portion of the expandable
prosthesis and also within the side port when the expandable prosthesis is in
both the radially collapsed and radially expanded conditions, whereby positioning the expandable prosthesis at the bifurcation region
such that the distal end portion of the expandable prosthesis is located in the
first branch lumen and the side port is aligned with the entrance zone to the
second branch lumen, the access device is adapted to provide percutaneous
translumenal access to the second branch lumen.
Claim 18
Dependent Claim
80 words
The endolumenal medical device assembly of claim 17, wherein
the access device further comprises a guidewire which has a proximal end
portion and a distal end portion with a shaped, radiopaque tip region which is
steerable by torquing the proximal end portion of the guidewire, the distal end
portion of the guidewire being engaged within the prosthesis passageway and
extending distally through the side port when the expandable prosthesis is in
both the radially collapsed and the radially expanded conditions.
Claim 19
Dependent Claim
147 words
The endolumenal medical device assembly of claim 17, wherein
the access device further comprises: a guidewire tracking member with a proximal end portion, a distal end
portion which is engaged within the prosthesis passageway and when the
expandable prosthesis is in both the radially collapsed and the radially
expanded conditions, and a guidewire lumen which is formed at least in part by
the distal end portion of the guidewire tracking member, the guidewire lumen
communicating externally of the guidewire tracking member through a distal
guidewire port located along the distal end portion of the guidewire tracking
member at or adjacent to the side port and also through a proximal guidewire
port located along the guidewire tracking member proximally of the prosthesis
passageway, the guidewire tracking member further being adapted to track
over a guidewire slideably received within the guidewire lumen through the
proximal and distal guidewire ports.
Claim 20
Dependent Claim
70 words
The endolumenal medical device assembly of claim 19, further
comprising: a guidewire which has a proximal end portion and a distal end portion
with a shaped, radiopaque tip region that is steerable by torquing the proximal
end portion of the guidewire, the distal end portion of the guidewire further
being adapted to slideably engage the guidewire tracking member within the
guidewire lumen and through the proximal and distal guidewire ports.
Claim 21
Dependent Claim
45 words
The endolumenal medical device assembly of claim 17, wherein
the expandable prosthesis further comprises: an endolumenal stent which is adapted to provide radial support to the
body lumen wall when the expandable prosthesis is expanded from the radially
collapsed condition to the radially expanded condition.
Claim 22
Dependent Claim
68 words
The endolumenal medical device assembly of claim 21, wherein
the endolumenal stent further comprises a tubular stent wall which is formed
by a plurality of integrated support members, the tubular stent wall further
including a plurality of gaps each being formed by a separation between at least
a portion of adjacent integrated support members, the side port being formed at
least in part by one of the gaps.
Claim 23
Dependent Claim
103 words
The endolumenal medical device assembly of claim 17, wherein
the expandable prosthesis is balloon expandable, and wherein the expansion
member further comprises an expansion member inflation lumen extending
between the proximal and distal end portions of the expansion member, the distal end portion of the expansion member further including an
expandable balloon which is fluidly coupled to the expandable member
inflation lumen and which is engaged within the prosthesis passageway, the proximal end portion of the expansion member further including a
coupler which is fluidly coupled to the expansion member inflation lumen and
which is adapted to couple to a pressurizeable fluid source.
Claim 24
Dependent Claim
61 words
The endolumenal medical device assembly of claim 17, wherein
the expandable prosthesis is self-expandable from an elastically deformed
condition in the radially collapsed condition to a resting condition in the
radially expanded condition, and wherein the expandable prosthesis is
constrained in the radially collapsed condition by the expansion member and is
unconstrained by the expansion member in the radially expanded condition.
Claim 25
Dependent Claim
72 words
The endolumenal medical device assembly of claim 24, wherein
the expansion member further comprises a sheath which forms a sheath lumen
and which is adjustable from a second constraining position, wherein the
expandable prosthesis is coaxially confined within the sheath lumen, to a
second releasing position, wherein the expandable prosthesis is released from
within the sheath lumen and is radially unconfined and self-expands to the
resting condition in the radially expanded condition.
Claim 26
Independent Claim
95 words
A method of engaging an expandable prosthesis within an
interior surface of a body lumen wall at a bifurcation region of the body lumen,
the expandable prosthesis having a longitudinal axis, a length along the
longitudinal axis, a prosthesis passageway which extends along the longitudinal
axis, and a side port located along the length and through which the prosthesis
passageway communicates externally of the expandable prosthesis, comprising: engaging a distal end portion of a dilator within the prosthesis
passageway and also within the side port while the expandable prosthesis is in a
radially collapsed condition.
Claim 27
Dependent Claim
115 words
The method of claim 26, wherein the expandable prosthesis
further includes a proximal end portion and a distal end portion such that the
side port is located between the proximal and distal end portions, and wherein
the bifurcation region includes first and second branch lumens each having an
entrance zone extending from a common branch lumen, the method further
comprising: positioning the expandable prosthesis within the bifurcation region such
that the proximal end portion of the expandable prosthesis is located within the
common branch lumen, the distal end portion of the expandable prosthesis is
located within the first branch lumen, and the side port is aligned with the
entrance zone to the second branch lumen.
Claim 28
Dependent Claim
55 words
The method of claim 27, wherein the side port has an initial
inner diameter, further comprising: after positioning the expandable prosthesis within the bifurcation
region, dilating the side port with the distal end portion of the dilator from the
initial inner diameter to an expanded inner diameter which is larger than the
initial inner diameter.
Claim 29
Dependent Claim
80 words
The method of claim 28, wherein the distal end portion of the
dilator includes an expandable balloon which is fluidly coupled to a
pressurizeable fluid source, the method of dilating the side port further
comprising: pressurizing the expandable balloon with fluid from the pressurizeable
fluid source such that the expandable balloon is expanded from a radially
collapsed condition to a radially expanded condition, such that the side port is
adjusted from the initial inner diameter to the expanded inner diameter.
Claim 30
Dependent Claim
43 words
The method of claim 28, further comprising: before dilating the side port with the dilator, engaging a distal end
portion of a guidewire within the prosthesis passageway, through the side port,
and within at least the entrance zone of the second branch lumen.
Claim 31
Dependent Claim
50 words
The method of claim 30, wherein the distal end portion of the
dilator further includes a guidewire tracking member which is positioned
within the prosthesis passageway and also within the side port, the method
further comprising slideably engaging the distal end portion of the guidewire
within the guidewire tracking member.
Claim 32
Dependent Claim
100 words
The method of claim 28, wherein the expandable prosthesis is
coupled to a distal end portion of an expansion member and is adjustable by the
expansion member from a radially collapsed condition to a radially expanded
condition, the method further comprising: adjusting the expandable prosthesis with the expansion member from
the radially collapsed condition to the radially expanded condition such that the
distal end portion of the expandable prosthesis circumferentially engages an
interior wall of the first branch lumen and such that the proximal end portion
of the expandable prosthesis circumferentially engages an interior wall of the
common branch lumen.
Claim 33
Dependent Claim
34 words
The method of claim 32, wherein the method of dilating the side
port is performed before adjusting the expandable prosthesis from the radially
collapsed condition to the radially expanded condition within the bifurcation
region.
Claim 34
Dependent Claim
32 words
The method of claim 32, wherein the method of dilating the side
port is performed during the adjusting of the expandable prosthesis from the
radially collapsed condition to the radially expanded condition.
Claim 35
Dependent Claim
30 words
The method of claim 32, wherein the method of dilating the side
port is performed after adjusting the expanded prosthesis from the radially
collapsed condition to the radially expanded condition.
Claim 36
Dependent Claim
90 words
The method of claim 35, wherein the distal end portion of the
dilator includes an expandable balloon which is positioned within the side port
and which is also fluidly coupled to a pressurizeable fluid source, the method
of dilating the side port further comprising: pressurizing the expandable balloon with fluid from the pressurizeable
fluid source such that the expandable balloon is adjusted from a radially
collapsed condition to a radially expanded condition, and such that the side port
is adjusted from the initial inner diameter to the expanded inner diameter.
Claim 37
Dependent Claim
197 words
The method of claim 36, further comprising: before adjusting the expandable prosthesis to its respective radially
expanded condition, advancing the expandable balloon distally beyond the side
port and into the second branch lumen; before or while adjusting the expandable prosthesis to its respective
radially expanded condition, and after advancing the expandable balloon
distally beyond the side port and into the second branch lumen, pressurizing
the expandable balloon with fluid from the pressurizeable fluid source such that
the expandable balloon is adjusted from its respective radially collapsed
condition to its respective radially expanded condition which circumferentially
engages an interior wall of the second branch lumen; while the expandable balloon is adjusted to its respective radially
expanded condition within the second branch lumen, adjusting the expandable
prosthesis to its respective radially expanded condition within the first branch
lumen and the common branch lumen; and after adjusting the expanded prosthesis to its respective radially
expanded condition within the first branch lumen and the common branch
lumen, adjusting the expandable balloon from its respective radially expanded
condition to its respective radially collapsed condition and then withdrawing
the expandable balloon proximally until it is positioned at least partially within
the side port.
Claim 38
Dependent Claim
34 words
The method of claim 37, wherein the method of dilating the side
port with the dilator is performed after withdrawing the expandable balloon
from the second branch lumen and proximally within the side port.
Claim 39
Independent Claim
96 words
A method of engaging an expandable prosthesis within an
interior surface of a body lumen wall at a bifurcation region of a body lumen,
the expandable prosthesis having a longitudinal axis, a length along the
longitudinal axis, a prosthesis passageway which extends along the longitudinal
axis, and a side port located along the length and through which the prosthesis
passageway communicates externally of the expandable prosthesis, comprising: positioning a distal end portion of an access device within the prosthesis
passageway and also within the side port while the expandable prosthesis is in a
radially collapsed condition.
Claim 40
Dependent Claim
12 words
The method of claim 39, wherein the access device comprises a
guidewire.
Claim 41
Dependent Claim
97 words
The method of claim 39, wherein the access device comprises a
tubular member which forms a guidewire lumen extending between a distal
access port located along the distal end portion of the access device and a
proximal access port located along the access device proximally of the
expandable prosthesis, the guidewire lumen being adapted to slideably receive
a guidewire within the guidewire lumen and through the distal and proximal
access ports, and wherein the method of positioning the distal end portion of
the access device further comprises positioning the distal guidewire port
distally of the side port.
Claim 42
Dependent Claim
23 words
The method of claim 41, further comprising slideably engaging
a guidewire within the guidewire lumen and through the distal and proximal
guidewire ports.
Claim 43
Dependent Claim
143 words
The method of claim 42, wherein the expandable prosthesis
further includes a proximal end portion and a distal end portion such that the
side port is located between the proximal and distal end portions, and wherein
the bifurcation region includes first and second branch lumens each having an
entrance zone extending from a common branch lumen, the method further
comprising: after engaging the distal end portion of the access device within the
prosthesis passageway and side port of the expandable prosthesis, positioning
the expandable prosthesis within the bifurcation region and while in the radially
collapsed condition such that the proximal end portion of the expandable
prosthesis is located within the common branch lumen, the distal end portion of
the expandable prosthesis is located within the first branch lumen, and the side
port is aligned with the entrance zone to the second branch lumen.
Claim 44
Dependent Claim
93 words
The method of claim 43, wherein the expandable prosthesis is
further coupled to a distal end portion of an expansion member which is
adapted to adjust the expandable prosthesis from the radially collapsed
condition to a radially expanded condition, the method further comprising: after positioning the expandable prosthesis within the bifurcation
region, adjusting the expandable prosthesis with the expansion member from
the radially collapsed condition to the radially expanded condition such that the
distal end portion circumferentially engages the first branch lumen and the
proximal end portion circumferentially engages the common branch lumen.
Claim 45
Dependent Claim
136 words
The method of claim 44, wherein the expandable prosthesis is
self-expandable and wherein the expansion member is a radially confining
sheath which includes a sheath lumen and which is adjustable from a first
position, wherein the expandable prosthesis is coaxially engaged within the
sheath lumen and is thereby radially confined in the radially collapsed
condition, to a second position, wherein the expandable member is removed
from the sheath lumen and self-expands to the radially expanded condition, the
method further comprising: during the positioning of the expandable member within the bifurcation
region, adjusting the radially confining sheath to the first position relative to
the expandable prosthesis; and during the adjusting of the expandable member to the radially expanded
condition within the bifurcation region, adjusting the radially confining sheath
to the second position relative to the expandable member.
Claim 46
Dependent Claim
129 words
The method of claim 44, wherein the expandable prosthesis is
balloon expandable and wherein the expansion member includes along its distal
end portion an expandable balloon which is fluidly coupled to a pressurizeable
fluid source and which is adjustable from a radially collapsed condition to a
radially expanded condition, the method further comprising: during the positioning of the expandable member within the bifurcation
region, adjusting the expandable balloon to its respective radially collapsed
condition which characterizes the respective radially collapsed condition for the
expandable prosthesis; and during the adjusting of the expandable member to the radially expanded
condition within the bifurcation region, adjusting the expandable balloon with
the pressurizeable fluid source to its respective radially expanded condition to
thereby adjust the expandable member to its respective radially expanded
condition.
Claim 47
Dependent Claim
273 words
An endolumenal medical device assembly for engaging an
interior surface of a body lumen wall at a bifurcation region of a body lumen,
comprising: an expandable prosthesis having an elongate prosthesis body with a
proximal end portion, a distal end portion, a length along a longitudinal axis
extending between the proximal and distal end portions, a prosthesis
passageway which extends along the length, and a side port which is positioned
along the length and through which the prosthesis passageway communicates
externally of the elongate prosthesis body, the expandable prosthesis further
being adjustable from a first radially collapsed condition, wherein the elongate
prosthesis body has a first collapsed outer diameter, to a first radially expanded
condition, wherein the elongate prosthesis body has an first expanded outer
diameter which is larger than the first collapsed outer diameter; and a lateral expandable prosthesis having a lateral prosthesis body with a
proximal end portion, a distal end portion, and a lateral prosthesis lumen
extending between a proximal lateral port located along the proximal end
portion of the lateral prosthesis body and a distal prosthesis port located along
the distal end portion of the lateral prosthesis body, the lateral expandable
prosthesis further being adjustable from a second radially collapsed condition,
wherein the lateral prosthesis body has a second collapsed outer diameter, to a
second radially expanded condition, wherein the lateral prosthesis body has a
second expanded outer diameter, wherein the proximal end portion of the lateral prosthesis body is
coupled to the elongate prosthesis body at a location adjacent to the side port
such that the proximal lateral port is aligned and in communication with the
side port.
Claim 48
Dependent Claim
108 words
The endolumenal medical device assembly of claim 47, wherein
the expandable prosthesis comprises: a plurality of generally circular members, each formed of a plurality
of substantially straight segments connected at axial bends; at least one pair of aligned axial bends between adjacent generally
circular members; the at least one pair of aligned axial bends between adjacent generally
circular members are connected together; and wherein at least one of the generally circular members defines the side
port and a portion of the proximal end portion of the lateral expandable
prosthesis is coupled to an axial bend of one of the plurality of generally
circular members defining the side port.
Claim 49
Dependent Claim
30 words
The endolumenal medical device assembly of claim 48, wherein
the side port is defined by gaps between two substantially straight segments
of one of the plurality of generally circular members.
Claim 50
Dependent Claim
22 words
The endolumenal medical device assembly of claim 48, wherein
the side port is defined by a gap between adjacent generally circular members.
Claim 51
Dependent Claim
111 words
The endolumenal medical device assembly of claim 47, wherein
the lateral expandable prosthesis comprises: a plurality of generally circular members, each formed of a plurality of
substantially straight segments connected at axial bends; at least one pair of aligned axial bends between adjacent generally circular
members; the at least one pair of aligned axial bends between adjacent generally
circular members are connected together; and wherein the generally circular member defining the proximal portion of
the lateral expandable prosthesis has an axial bend coupled to the elongate
prosthesis body at a location adjacent to the side port such that the proximal
lateral port is aligned and in communication with the side port.
Claim 52
Dependent Claim
143 words
The endolumenal medical device assembly of claim 48, wherein
the lateral expandable prosthesis comprises: a plurality of generally circular members, each formed of a plurality of
substantially straight segments connected at axial bends; one of the plurality of generally circular members defining the proximal
end portion of the lateral expandable prosthesis and another of the plurality of
generally circular members defining the distal end portion of the lateral
expandable prosthesis; at least one pair of aligned axial bends between adjacent generally circular
members; the at least one pair of aligned axial bends between adjacent generally
circular members are connected together; and wherein an axial bend of the generally circular member defining the
proximal end portion of the lateral expandable prosthesis is coupled to an axial
bend of one of the plurality of generally circular members defining the side
port along the expandable prosthesis.
Claim 53
Dependent Claim
93 words
The endolumenal medical device assembly of claim 47, wherein
the endolumenal prosthesis has a first longitudinal axis and the lateral
expandable prosthesis has a second longitudinal axis, and wherein the lateral
expandable prosthesis is further adjustable from first lateral position, which is
adjacent to the distal end portion of the endolumenal prosthesis such that the
second longitudinal axis is substantially parallel to the first longitudinal axis, to
a second lateral position, which is radially displaced from the first lateral
position such that the second longitudinal axis diverges distally from the first
longitudinal axis.
Claim 54
Dependent Claim
70 words
The endolumenal medical device assembly of claim 53, the
bifurcation region further including at least a first and a second branch lumen
each having an entrance zone extending from a common branch lumen such
that the first and second branch lumens diverge at a bifurcation angle, and
wherein the second lateral position the second longitudinal axis diverges from
the first longitudinal axis at an angle which approximates the bifurcation angle.
Claim 55
Dependent Claim
33 words
The endolumenal medical device assembly of claim 53, wherein
in the second lateral position the second longitudinal axis diverges from the
first longitudinal axis at an angle which is at least 15 degrees.
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