Stent cannulation guiding device for bifurcated stent and method of use

Abstract

The present invention is directed to an intraluminal guiding device having an expandable guiding member so as to facilitate and overcome the difficulties associated with obtaining contra-lateral leg access of a bifurcated stent or a bifurcated stent graft with a second guidewire and a method for treating abdominal aortic aneurysms with such a device. The guiding device comprises a pre-loaded second wire positioned within the contra-lateral leg which facilitates access to said leg in accordance with the present invention.

What is claimed is: 
     
         1 . An intraluminal delivery device comprising:
 an elongate inner tubular member having a proximal region and a distal region and being adapted to engage over a guidewire, the distal region being configured to receive a bifurcated intraluminal device having a first tubular leg and a second leg tubular, the first and the second tubular leg each having a distal opening, wherein the distal region of the elongated inner tubular member is positioned within the first leg; and   a pre-loaded guidewire segment having a length shorter than the elongated inner tubular member, the pre-loaded guidewire segment being attached to the inner tubular member and positioned within the second leg and extending there through.   
     
     
         2 . The intraluminal delivery device of  claim 1  further comprising a sheath having a proximal end and a distal end positioned concentrically around at least a portion of the elongated inner tubular member, wherein the sheath constrains the expansion of the intraluminal device and whereby relative movement between the sheath and the inner tubular member allows for the delivery of the intraluminal device. 
     
     
         3 . The intraluminal guiding device according to  claims 1  wherein said sheath further comprises a lubricous coating. 
     
     
         4 . The intraluminal guiding device according to  claims 1  wherein the pre-loaded guidewire segment extends past the distal opening of the second leg. 
     
     
         5 . The intraluminal guiding device according to  claims 1  wherein bifurcated intraluminal device has a proximal tubular trunk region that bifurcates into the first and the second leg at a bifurcation point, wherein the pre-loaded guidewire segment is attached to the elongated inner tubular member proximal the bifurcation point. 
     
     
         6 . The intraluminal guiding device according to  claims 5  wherein the pre-loaded guidewire segment is attached to the elongated inner tubular member within the trunk section. 
     
     
         7 . A method of delivering a bifurcated stent and extension endo-leg comprising the steps of:
 delivering a bifurcated stent over a first elongated guidewire through a first vessel, the first elongated guidewire having a proximal and first distal end, the bifurcated stent having a first end and a second end wherein said second end is bifurcated resulting in first and second luminal opening, each opening providing a uninterrupted flow path to the first end and wherein said first guidewire is positioned within the first luminal opening passing through the uninterrupted flow path and out the first end and wherein said first guidewire has an ancillary length attached to the distal end resulting in a second distal end positioned away from said first distal end and positioned within the second luminal opening extending beyond said opening;   delivering over a second guidewire through a second vessel a snare device wherein said snare device can be operatively attached to the second distal end of the first guidewire;   attaching said snare device to the second distal end of the first guidewire;   advancing said first guidewire beyond the first end of the stent resulting in said second guidewire to be positioned in the second luminal opening; and   delivering an extension endo-leg having a first end and a second end over said second guidewire through a second vessel wherein the first end of the extension endo-leg is positioned within the second luminal opening of the bifurcated stent and the second end of the extension endo-leg is positioned with the second vessel resulting in an extension of the uninterrupted flow path.   
     
     
         8 . A method of delivering an intraluminal device to the location in a body lumen, the intraluminal device having a main body including a proximal trunk portion and distal first and second tubular leg portions, and a separate and detached endo-leg portion, the method comprising the steps of:
 delivering a first delivery device to a location in the body lumen, the first delivery device including a first elongate member and a pre-loaded wire attached thereto, and carrying the main body of the intraluminal device such that the first elongate member extends through the proximal trunk portion and distal first leg portion of the intraluminal main body portion;   deploying the main body of the intraluminal device at the location in the body lumen;   positioning the first delivery device within the main body of the deployed intraluminal device such that a free end of the pre-loaded wire extends into the second leg of the intraluminal main body portion;   delivering a second delivery device having a second elongate member to the location in the body lumen, the second elongate member having a capturing mechanism associated therewith configured for grasping the pre-loaded wire, the second delivery device carrying the endo-leg of the intraluminal device;   grasping the pre-loaded wire with the capturing mechanism associated with the second delivery device;   advancing the second elongate member into the lumen of the second tubular leg to position the endo-leg in the desired location; and   deploying the endo-leg.   
     
     
         9 . The method of  claim 8  further comprising the step of delivering a first guidewire to the location in the body lumen through a first vessel. 
     
     
         10 . The method of  claim 9  wherein the step of delivering the first delivery device to a location in the body lumen comprises advancing the first delivery device over the first guidewire to the location. 
     
     
         11 . The method of  claim 8  wherein the first delivery device further includes a first sheath configured to constrain the intraluminal device in a radially compressed configuration, and wherein the step of deploying the main body portion of the intraluminal device comprises retracting the first sheath relative to the first elongate member. 
     
     
         12 . The method of  claim 8  further comprising the step of extending the pre-loaded wire in a distal direction past the distal end of the second tubular leg portion. 
     
     
         13 . The method of  claim 8  further comprising the step of delivering a second guidewire to the location in the body lumen through a second vessel. 
     
     
         14 . The method of  claim 13  wherein the step of delivering a second elongate member to a location in the body lumen comprises advancing the second elongate member over the second guidewire to the location. 
     
     
         15 . The method of  claim 8  further comprising extending the capture mechanism from second elongate member. 
     
     
         16 . The method of  claim 8  wherein the capture mechanism includes a snare, and the step of grasping the pre-loaded wire comprises snaring the pre-loaded wire with the snare. 
     
     
         17 . The method of  claim 8  wherein the step of advancing the second elongate member into the lumen of the second tubular leg comprises moving the first delivery system in a proximal direction. 
     
     
         18 . The method of  claim 8  wherein the second delivery device further includes a second sheath configured to constrain the endo-leg in a radially compressed configuration, and wherein the step of deploying the endo-leg comprises retracting the second sheath relative to the second elongate member.