Side Branch Stent Alignment Through a Main Stent Side Hole
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Solution Overview
Problem
Conventional stents struggle with treating bifurcated vessels due to issues such as impaired blood flow, difficulty in accessing daughter vessels, and high rates of in-stent restenosis, particularly when deployed at or near vessel bifurcation points, and systemic drug delivery methods are ineffective for localized treatment.
Innovation Solution
A catheter system with independently operable mother and daughter vessel guidewires and balloons, allowing for precise alignment and deployment of stents in bifurcations, combined with localized drug delivery via stents, to address these challenges.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Strength
If conventional stents are deployed at vessel bifurcations to treat occlusions, then vessel support is improved, but blood flow is impeded and access to daughter vessels is blocked
Solution Approach 1:
The stent is divided into multiple segments including a mother vessel portion and a daughter vessel portion, allowing each segment to be optimized for its specific function. The mother vessel portion provides structural support while the daughter vessel portion maintains patency and access to side branches.
Solution Approach 2:
The stent design incorporates a three-dimensional structure with struts arranged in specific patterns that create channels and spaces for blood flow in multiple directions, allowing simultaneous support of the main vessel and access to daughter vessels.
2Reliability
If stent cell structure size is minimized to promote coverage and prevent tissue prolapse, then vessel wall support is improved, but access for future daughter stent implantation is reduced
Solution Approach 1:
Different regions of the stent have different cell structure characteristics. The mother vessel portion has smaller cells for optimal support and tissue coverage, while the daughter vessel portion has larger cells that facilitate access and prevent jailing of future daughter stents.
3Productivity
If conventional stents are used to treat bifurcations, then immediate vessel patency is achieved, but in-stent restenosis occurs at high rates
Solution Approach 1:
The stent is pre-coated with anti-restenosis drugs and/or bioactive agents before implantation. This preliminary preparation ensures that as soon as the stent is deployed, therapeutic substances are released to prevent intimal hyperplasia and restenosis, addressing the problem before it occurs.
4Ease of operation
If systemic drug delivery is used to treat restenosis, then drug distribution is simplified, but localized treatment effectiveness is reduced
Solution Approach 1:
The drug delivery function is extracted from the systemic circulation and integrated directly into the stent structure. The stent serves as a localized delivery vehicle, concentrating therapeutic agents at the treatment site rather than distributing them systemically, thereby improving local effectiveness.
Solution Approach 2:
The stent performs multiple functions simultaneously: mechanical support of the vessel wall, prevention of restenosis through drug delivery, and maintenance of blood flow. This multi-functionality eliminates the need for separate systemic drug therapy while achieving both structural and pharmacological goals.
Data Source
AI summary
The present disclosure relates to a method for deploying a side branch stent in a bifurcated vessel that already contains a pre-existing main branch stent. The method involves inserting guide wires into both the main and side branches, and advancing a dual catheter delivery system, where only the side branch catheter carries the side branch stent. The system is retracted to position behind a side hole of the pre-existing stent, and guide wires are adjusted to reduce crossing. The catheters are aligned using marker bands and advanced towards the bifurcation until a specific tension is achieved. A balloon on the side branch catheter is then inflated to deploy the side branch stent through the side hole. This is followed by a kissing balloon inflation for optimal stent apposition. The catheters are then deflated and removed, leaving the stents aligned without gaps, ensuring effective treatment of the bifurcation.