Methods and systems for ostial stenting of a bifurcation

摘要

A system for treating a bifurcation includes first and second delivery catheters, each having an expandable member. A stent having a side hole is disposed on the second delivery catheter. A portion of the first delivery catheter is disposed under a portion of the stent. The first delivery catheter is slidable relative to the second delivery catheter, and the first delivery catheter passes through the side hole. Expansion of the first expandable member expands a proximal portion of the stent in a main branch vessel, and expansion of the second expandable member expands a distal portion of the stent in a side branch vessel.

主权项

1. A method of treating a bifurcated vessel, said method comprising:
providing a first delivery catheter and a second delivery catheter, wherein the first delivery catheter comprises a first elongate shaft, and a first expandable member near a distal end of the first elongate shaft, and wherein the second delivery catheter comprises a second elongate shaft, a second expandable member near a distal end of the second elongate shaft, and a stent disposed over the second expandable member, the stent having a sidewall with a side hole therethrough, wherein the a portion of the first elongate shaft is disposed under the stent and the first elongate shaft passes through the side hole in the stent, and wherein the first expandable member is distal to the second expandable member; advancing both the first delivery catheter and the second delivery catheter through a vessel toward the bifurcation while the first expandable member is distal to the second expandable member, wherein the bifurcation comprises a main branch vessel having a main branch lesion and a side branch extending from the main branch and having a side branch lesion, wherein the stent is advanced until the stent is disposed in both the main branch and in the side branch, and wherein the first expandable member is advanced until the first expandable member is disposed in the main branch past the bifurcation with a proximal working end of the first expandable member distal of the side hole of the stent; proximally retracting the first elongate shaft relative to the second elongate shaft so that the first elongate shaft is retracted under a proximal portion of the stent, the proximal working end of the first expandable member is proximal of a proximal end of the stent, and a portion of the first expandable member is disposed under the stent while another portion of the first expandable member remains unconstrained by the stent and disposed in the main branch distal to the side hole in the stent; radially expanding the first expandable member thereby expanding the proximal portion of the stent into engagement with the main branch lesion and a wall of the main branch, and expanding the side hole; and radially expanding the second expandable member thereby expanding a distal portion of the stent into engagement with the lesion in the side branch and a wall of the side branch.