Everting stent and stent delivery system

Abstract

Devices and methods for delivering stents to target vessel regions, including stent delivery through microcatheters to narrow cerebral arteries. One stent delivery device includes a stent having the distal region everted over the distal end of a delivery tube, having the everted stent distal end captured by a distal element of a elongate release member disposed through the delivery tube. The delivery tube can have a distal taper to a small profile distal end. The everted stent distal region can be captured between the release member distal element and the surrounding delivery tube distal region walls. The captured and everted stent can be distally advanced to a target site, followed by manipulating the release member to free the captured stent. Some devices utilize distal advancement of the release member while other devices use proximal retraction of the release member to free the captured stent distal end. Once released, the stent is free to self-expand or be expanded against the surrounding blockage and/or vessel walls. In some methods, a guide catheter or microcatheter is also included and disposed about the everted and captured stent to advance the stent, delivery tube, and release member to a location near the site to be stented. The devices and methods provide stent delivery not requiring an enclosing delivery sheath about the stent. The everted stent can thus have a very small distal profile enabling small diameter vessels to be crossed and treated.

1 . An elongate stent delivery assembly, the assembly comprising: 
 a delivery tube having a distal region, a proximal region, and a lumen therethrough;    a stent including a tubular body having a distal region, a proximal region, and an intermediate region disposed between the distal region and the proximal region, the stent body having a lumen therethrough, wherein the stent distal region is disposed over the delivery tube distal region, and everted over the delivery tube distal end, such that the stent body distal end is disposed within the delivery tube distal region lumen; and    an elongate release member having a proximal region, a distal region, and a distal end, wherein the release member distal region is releasably coupled to the everted stent body distal region, such that releasing the releasable coupling between the release member distal region and the everted stent body distal region frees the stent from the delivery tube.    
   
   
       2 . An assembly as in  claim 1 , wherein the stent is biased to radially expand when freed from the delivery tube.  
   
   
       3 . An assembly as in  claim 1 , wherein the elongate release member distal profile is dimensioned to form a friction fit between the everted stent body distal end disposed about the elongate release member distal portion and the delivery tube distal region disposed about the everted stent distal region.  
   
   
       4 . An assembly as in  claim 3 , wherein the elongate release member has sufficient strength in compression to allow for advancing the release member distal region distally from the delivery tube distal region, such that the everted stent is released from the delivery tube distal end.  
   
   
       5 . An assembly as in  claim 4 , wherein the release member proximal region is externally accessible.  
   
   
       6 . An assembly as in  claim 3 , wherein the elongate release member has sufficient strength in tension to allow for retracting the release member distal region proximally free of the everted stent body distal region, thereby releasing the stent from the delivery tube.  
   
   
       7 . An assembly as in  claim 6 , wherein the release member proximal region is externally accessible.  
   
   
       8 . An assembly as in  claim 3 , wherein the delivery tube has an intermediate region disposed between the delivery tube distal and proximal regions, wherein the delivery tube intermediate region has an inside diameter dimensioned to provide columnar support for the enclosed release member.  
   
   
       9 . An assembly as in  claim 1 , wherein the delivery tube has an intermediate region, wherein the delivery tube distal region is tapered, having a smaller outer diameter at the delivery tube distal end than in the delivery tube intermediate region.  
   
   
       10 . An assembly as in  claim 1 , further comprising a microcatheter having a distal region, a proximal region, and a lumen through at least the distal region, wherein the microcatheter distal region is disposed over the delivery tube distal region.  
   
   
       11 . An elongate stent delivery device for delivering a stent, the stent including a tubular body having a distal region delivery tube distal region lumen, the device comprising: 
 a delivery shaft having a distal region, a proximal region, and a lumen through at least the shaft distal region; and    an elongate release member having a proximal region, a distal region, and a distal end, wherein the elongate release member distal region is disposed within the delivery shaft distal region lumen, wherein the release member distal region is cooperatively dimensioned to releasably secure to the stent body distal region between the release member shaft distal region and the delivery shaft distal region, such that releasing the releasable coupling between the release member distal region and the stent body distal region frees the stent from the delivery shaft.    
   
   
       12 . A device as in  claim 11 , wherein the elongate release member distal profile is dimensioned to form a friction fit between the stent body distal end disposed about the elongate release member distal portion and the delivery shaft distal region disposed about the stent distal region.  
   
   
       13 . A device as in  claim 12 , wherein the elongate release member has sufficient strength in compression to allow for advancing the release member distal region distally from the delivery shaft distal region, such that the stent is released from the delivery tube distal end.  
   
   
       14 . A device as in  claim 13 , wherein the release member proximal region is externally accessible.  
   
   
       15 . A device as in  claim 12 , wherein the elongate release member has sufficient strength in tension to allow for retracting the release member distal region proximally free of the stent body distal region, thereby releasing the stent from the delivery shaft.  
   
   
       16 . An assembly as in  claim 13 , wherein the release member proximal region is externally accessible.  
   
   
       17 . A device as in  claim 11 , wherein the delivery shaft has a lumen through a majority of its length.  
   
   
       18 . A device as in  claim 17 , wherein the delivery shaft has an intermediate region disposed between the delivery shaft distal and proximal regions, wherein the delivery shaft intermediate region lumen has an inside diameter dimensioned to provide columnar support for the enclosed release member.  
   
   
       19 . A device as in  claim 11 , further comprising a microcatheter having a distal region, a proximal region, and a lumen through at least the distal region, wherein the microcatheter distal region is disposed over the delivery shaft distal region.  
   
   
       20 . A method for delivering a tubular stent to a target vessel region, the method comprising the steps of: 
 providing a stent having a substantially tubular body, a distal region, a proximal region, an intermediate region disposed between the distal and proximal regions, and a distal end;    providing a delivery shaft having a distal region, a proximal region, and a distal end, wherein the distal region has a lumen therethrough, wherein the stent distal region is everted over the delivery shaft distal end such that the stent proximal and intermediate regions are disposed over the delivery shaft while the stent distal end is disposed inside the delivery tube distal region lumen;    providing an elongate release member having a distal region, a proximal region, an intermediate region disposed between the distal and proximal regions, and a distal end, wherein the release member distal region is releasably coupled to the everted stent distal region to secure the everted stent to the release member;    advancing the everted stent, delivery shaft, and release member distally to a location near the target vessel region; and    releasing the release member from the stent distal region such that the stent is no longer secured to the delivery shaft distal region.    
   
   
       21 . A method as in  claim 20 , wherein the releasing step includes proximally retracting the release member such that the everted stent distal region is no longer captured between the release member distal region and the delivery shaft distal region.  
   
   
       22 . A method as in  claim 21 , wherein the release member proximal region is externally accessible, wherein the proximally retracting step includes manipulating the release member from the release member proximal region.  
   
   
       23 . A method as in  claim 20 , wherein the releasing step includes distally advancing the release member distal region, such that the everted stent distal region is no longer captured between the elongate release member distal region and the delivery shaft distal region.  
   
   
       24 . A method as in  claim 23 , wherein the release member proximal region is externally accessible, wherein the distally advancing step includes manipulating the release member from the release member proximal region.  
   
   
       25 . A method as in  claim 20 , further comprising radially expanding the stent after the releasing step.  
   
   
       26 . A method as in  claim 24 , wherein the radially expanding step includes allowing the stent to radially expand upon release, wherein the provided stent is biased to expand radially when freed from the delivery shaft distal region.  
   
   
       27 . A method as in  claim 25 , wherein the radially expanding step includes radially expanding the stent from within the stent lumen after the releasing step.  
   
   
       28 . A method as in  claim 27 , wherein the radially expanding step includes providing an inflatable balloon catheter having a distal region and a proximal region, having an inflatable balloon disposed about the distal region, wherein the radially expanding step includes inflating the balloon catheter within the stent after the releasing step to radially expand the stent at the target vessel region.  
   
   
       29 . A method as in  claim 20 , further comprising: 
 providing a microcatheter having a distal region, a proximal region, an intermediate region disposed between the distal and proximal regions, a distal end, and a lumen therethrough;    advancing the microcatheter to near the target vessel region; and    distally advancing the everted stent, delivery shaft, and release rod within the microcatheter; and    advancing the everted stent, delivery shaft, and release rod distally from the microcatheter distal end across the target vessel region.    
   
   
       30 . A method as in  claim 20 , further comprising: 
 providing a microcatheter having a distal region, a proximal region, an intermediate region disposed between the distal and proximal regions, a distal end, and a lumen therethrough;    advancing the microcatheter to near the target vessel region; and    distally advancing the everted stent, delivery shaft, and release rod within the microcatheter;    advancing the microcatheter, everted stent, delivery shaft, and release rod distally across the target vessel region;    proximally retracting the microcatheter from the target vessel region to expose the stent; and    manipulating the release member to release the stent from the release member and delivery shaft.