Apparatus and methods for protected angioplasty and stenting at a carotid bifurcation

Abstract

Apparatus and methods are described for performing protected angioplasty and stenting of a patient's carotid bifurcation. An integrated catheter system can be configured in a rapid- exchange version or in an over-the-wire version. The catheter system includes a self- expanding stent, a stent delivery sheath, a combination angioplasty balloon catheter and stent pusher catheter, an embolic protection device and, in the rapid-exchange version, an auto-releasing sheath. The method includes: inserting a guiding catheter to the carotid bifurcation; inserting the catheter system through the guiding catheter; advancing the embolic protection device beyond the lesion; positioning the stent and balloon segment of the catheter system at the lesion; releasing the self-expanding stent; pulling the stent delivery sheath back into the guiding catheter; positioning and deploying the protection member; advancing the combination angioplasty balloon catheter and stent pusher catheter and inflating the angioplasty balloon within the lesion; deflating the angioplasty balloon and withdrawing the combination angioplasty balloon catheter and stent pusher catheter and stent delivery sheath together; and aspirating potential emboli through the guiding catheter.

Description

technical field [0001] The present invention relates generally to catheter based treatment of vascular disease. More particularly, the present invention relates to an improved device and method for stenting angioplasty using embolic protection to capture potential embolic debris. The device and method are particularly useful for treating vascular disease at the carotid bifurcation. Background technique [0002] Interventional therapy including vascular stenting has shown great advantage in the treatment of vascular occlusive diseases. Percutaneous transluminal angioplasty (PTA) (Percutaneous recanalization after chronic arterial occlusion with a new dilator-catheter modification of the Dotter technique; Dtsch Med Wochenschr 1974 Dec 6;99(49):2502-10, 2511). Gruentzig et al. reported the first case of percutaneous transluminal dilatation of chronic coronary stenosis (Percutaneous transluminal dilatation of chronic coronary stenosis; First experiences, Schweiz MedWochenschr...

AI Technical Summary

Problems solved by technology

Commercial systems tend to be expensive and slightly cumbersome to use

Another disadvantage of using a distal embolic protection device is that placement of the device distal to the treatment site results in spasm of the distal internal carotid artery, which can sometimes lead to serious complications

Other solutions such as regurgitation or proximal occlusion of the carotid artery have not been shown to be effective in reducing embolic complications

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