Stent and catheter assembly and method for treating bifurcations

Abstract

An apparatus and method is provided for stenting bifurcated vessels. A proximal angled stent is configured for implanting in a side-branch vessel wherein the proximal angled stent has an angulated portion that corresponds to the angle formed by the intersection of the side-branch vessel and the main vessel so that all portions of the side-branch vessel at the bifurcation are covered by the proximal angled stent. A main-vessel stent is provided for implanting in the main vessel, wherein the main-vessel stent has an aperture or stent cell that aligns with the opening to the side-branch vessel to permit unobstructed blood flow between the main vessel and the side-branch vessel. Side-branch and main-vessel catheter assemblies are advanced over a pair of guide wires for delivering, appropriately orienting, and implanting the proximal angled stent and the apertured stent.

1 - 32 . (canceled) 
     
     
         33 . A catheter assembly for treating bifurcated vessels having a side-branch vessel and a main vessel, comprising:
 a catheter having a proximal end and a distal end;   an expandable member proximal to the distal end of the catheter;   a tracking guide wire lumen extending within at least a portion of the catheter;   a tracking guide wire having a distal end and a proximal end and sized for slidable movement within the tracking guide wire lumen;   a positioning guide wire lumen disposed on an outer surface of the expandable member and extending along the length of the expandable member wherein at least a portion of the positioning guide wire lumen is external to the catheter;   a positioning guide wire having a distal end and a proximal end and sized for slidable movement within the positioning guide wire lumen; and   the distal ends of the tracking and positioning guide wires extend out of the patient's body and can be manipulated so that the distal end of the positioning guide wire is advanced in the side branch vessel and the distal end of the tracking guide wire is advanced in the main vessel.   
     
     
         34 . The catheter assembly of  claim 33 , wherein the tracking guide wire lumen is an over-the-wire guide wire lumen and extends through the catheter from the catheter proximal end to the catheter distal end. 
     
     
         35 . The catheter assembly of  claim 33 , wherein the positioning guide wire lumen is a rapid exchange guide wire lumen and extends through the catheter from the catheter proximal end to a point proximal to the expandable member wherein the positioning guide wire lumen extends along an outer surface of the catheter and onto the outer surface of the expandable member. 
     
     
         36 . The catheter assembly of  claim 35 , wherein the portion of the positioning guide wire lumen on the surface of the catheter is a tube attached to the catheter outer surface. 
     
     
         37 . The catheter assembly of  claim 36 , wherein the positioning guide wire slidably advances through the positioning guide wire lumen and the tube so that the distal end of the positioning guide wire advances into the side branch vessel. 
     
     
         38 . The catheter assembly of  claim 36 , wherein the positioning guide wire lumen has a distal end positioned on the outer surface of the expandable member and at a distal end of the expandable member. 
     
     
         39 . The catheter assembly of  claim 38 , wherein a stent is mounted on the expandable member and covers at least a portion of the positioning guide wire lumen. 
     
     
         40 . The catheter assembly of  claim 39 , wherein the distal end of the positioning guide wire lumen extends distally of a distal end of the stent. 
     
     
         41 . The catheter assembly of  claim 33 , wherein a distal end of the positioning guide wire lumen ends at about a distal taper of the expandable member. 
     
     
         42 . The catheter assembly of  claim 33 , wherein the distal section of the positioning guide wire lumen is attached to a distal tip of the catheter. 
     
     
         43 . The catheter assembly of  claim 42 , wherein the distal section of the positioning guide wire lumen is a dead end lumen. 
     
     
         44 . The catheter assembly of  claim 43 , wherein the distal end of the positioning guide wire is configured for slidable movement into and out of the dead end lumen.