Methods and devices for protecting a passageway in a body when advancing devices through the passageway

Abstract

A liner is advanced through a narrowed region in a vessel such as the internal carotid artery. The liner is advanced through the narrowed region in a collapsed position. A stent is then advanced through the liner and expanded to open the narrowed region. The liner may also have an anchor which expands an end of the liner before the stent is introduced.

1 . A method of opening a narrowed region in a blood vessel, comprising the steps of: 
 providing a liner movable from a collapsed condition to an expanded condition;    advancing the liner to a narrowed region of a blood vessel with the liner in the collapsed position;    passing at least a portion of the liner through the narrowed region of the blood vessel in the collapsed position;    positioning a stent in the liner so that the stent is also positioned in the narrowed region of the blood vessel, the liner preventing the stent from contacting the narrowed region of the blood vessel; and    expanding the stent to open the narrowed region of the vessel.    
   
   
       2 . The method of  claim 1 , wherein: 
 the advancing and passing steps are carried out with the blood vessel being a vessel selected from the group comprising the internal carotid artery and saphenous vein graft.    
   
   
       3 . The method of  claim 1 , further comprising the step of: 
 expanding the liner before expanding the stent.    
   
   
       4 . The method of  claim 1 , wherein: 
 the liner is expanded by the stent.    
   
   
       5 . The method of  claim 1 , wherein: 
 the providing step is carried out with the liner being mounted to a delivery catheter.    
   
   
       6 . The method of  claim 1 , wherein: 
 the providing step is carried out with the liner having an expandable anchor coupled to the liner.    
   
   
       7 . The method of  claim 6 , wherein: the anchor is attached to the proximal end of the liner.  
   
   
       8 . The method of  claim 6 , further comprising the step of: 
 expanding the anchor with a balloon.    
   
   
       9 . The method of  claim 6 , further comprising the steps of: 
 holding the anchor in a collapsed position; and the expanding step is carried out by releasing the anchor so that the anchor moves into contact with the vessel wall and toward an expanded condition.    
   
   
       10 . The method of  claim 9 , wherein: 
 the anchor is expanded in the internal carotid artery.    
   
   
       11 . The method of  claim 10 , wherein: 
 the anchor expanding step is carried out so that the anchor is positioned at the bifurcation of the internal and external carotid arteries.    
   
   
       12 . The method of  claim 1 , wherein: 
 the providing step is carried out with the liner having a number of folded sections in the collapsed position.    
   
   
       13 . The method of  claim 12 , wherein: 
 the folds are separated by longitudinal creases.    
   
   
       14 . The method of  claim 12 , wherein: 
 the providing step is carried out with the folded sections being wrapped.    
   
   
       15 . The method of  claim 12 , wherein: 
 the providing step is carried out with at least two folded sections.    
   
   
       16 . The method of  claim 12 , wherein: 
 the providing step is carried out with the folded sections being adhered to one another to hold the folded sections in the collapsed position.    
   
   
       17 . The method of  claim 16 , wherein: 
 the providing step is carried out with the folded sections adhering to one another by application of heat to the folded sections.    
   
   
       18 . The method of  claim 16 , wherein: 
 the providing step is carried out with the folded sections adhering to one another with an adhesive.    
   
   
       19 . The method of  claim 16 , wherein: 
 the providing step is carried out with the folded sections being adhered to one another with gelatin, sucrose, glue, low molecular weight polyvinyl alcohol, suture, or fusion or soldered with radiopaque wire or ribbon.    
   
   
       20 . The method of  claim 1 , wherein: 
 the providing step is carried out with the liner being at least partially covered by a coating in the collapsed position, the coating dissolving in blood.    
   
   
       21 . The method of  claim 1 , wherein: 
 the providing step is carried out with the distal end of the liner being covered with a coating which forms a curved, atraumatic surface and covers a distal end of the folded sections.    
   
   
       22 . The method of  claim 1 , wherein: 
 the providing step is carried out with the liner being carried by a delivery catheter, the liner extending from a distal end of the delivery catheter.    
   
   
       23 . The method of  claim 1 , wherein: 
 the advancing the step is carried out by advancing the liner over a guidewire.    
   
   
       24 . The method of  claim 23 , wherein: 
 the providing step is carried out with the liner having a radial thickness of less than 0.020 inch in the collapsed position, the thickness being measured in a radial direction relative to a hole in which a guidewire is positioned.    
   
   
       25 . A method of protecting a body passage, comprising the steps of: 
 providing a liner movable from a collapsed condition to an expanded condition, the liner everting when moving from the collapsed condition to the expanded condition;    advancing the liner to a region of a passageway in a body with the liner in the collapsed position;    passing at least a portion of the liner through the region of the passageway in the collapsed position, at least a portion of the liner everting when moving from the collapsed position to the expanded position;    positioning a device in the liner so that the device is also positioned in the region of the passageway, the liner preventing the device from contacting the region of the passageway.    
   
   
       26 . A device for protecting a passageway in a body when passing other devices through the passageway, comprising: 
 a delivery catheter having a distal end;    and a liner coupled to the delivery catheter, the liner being movable from a collapsed position to an expanded position, the liner extending for a length of at least 2 cm and having a diameter of no more than 0.060 inch along the length when in the collapsed position.    
   
   
       27 - 67 . Canceled