Methods and apparatus are provided for renal neuromodulation using a pulsed electric field to effectuate electroporation or electrofusion. It is expected that renal neuromodulation (e.g., denervation) may, among other things, reduce expansion of an acute myocardial infarction, reduce or prevent the onset of morphological changes that are affiliated with congestive heart failure, and/or be efficacious in the treatment of end stage renal disease. Embodiments of the present invention are configured for percutaneous intravascular delivery of pulsed electric fields to achieve such neuromodulation.

Methods and apparatus for renal neuromodulation

The present invention concerns novel stent apparatuses for use in treating lesions at or near the bifurcation point in bifurcated cardiac, coronary, renal, peripheral vascular, gastrointestinal, pulmonary, urinary and neurovascular vessels and brain vessels More particularly, the invention concerns a stent apparatus with at least one side opening which may further comprise an extendable stent portion laterally extending from the side opening and at least partly in registry with the wall of the side opening Devices constructed in accordance with the invention include, singularly or in combination, a main expandable stent comprising at least one substantially circular side opening located between its proximal and distal end openings, which side opening may further comprise an expandable portion extending radially outward from the edges of the side opening; and a branch stent comprising proximal and distal end openings and which may further comprise a contacting portion at its proximal end, and which may optionally be constructed to form either a perpendicular branch or a non-perpendicular branch when inserted through a side opening of the main stent The stents of the invention are marked with, or at least partially constructed of, a material which is imageable during intraluminal catheterization techniques, most preferably but not limited to ultrasound and x-ray

Extendible Stent Apparatus

An expandable venous valve having a support structure (11) that configured to enlarge the area adjacent to the valve structure (12) such that the flow patterns of retrograde flow are modified in a way that facilitates the flushing of the pockets at the base of the valve area to prevent stagnation of bodily fluid, which in the venous system, can lead to thrombus formation. The enlarged pocket areas can be created by forming an artificial sinus (34) adjacent the valve structure in an unsupported section of vessel wall between two support frame section or the support frame can comprise an expanded-diameter intermediate or proximal section that forms an artificial sinus adjacent the valve structure. In another group of embodiments, the attachment pathway between opposing leaflets and the support frame and/or vessel wall comprises a proximal portion that places the leaflets in extended contact with one another and a distal portion forms a large angle with respect to the adjacent walls such that a large pocket is created at the base of the leaflets. In one embodiment, the attachment pathway extends distally along a pair of substantially parallel longitudinal attachment struts to create an extended leaflet contact area, then angles circumferentially and distally from the former along distal attachment struts to define the bottom edge of the leaflets.

Artificial valve prosthesis with improved flow dynamics

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.

Stent and catheter assembly and method for treating bifurcations

An expandable stent having a proximal end and a distal end in communication with one another, and a tubular wall disposed between the proximal end and the distal end. The tubular wall has a longitudinal axis and a porous surface defined by a plurality of intersecting members comprising a series of longitudinal struts disposed substantially parallel to the longitudinal axis of the stent. Each longitudinal strut in the series comprises flexure members for substantially complementary extension and compression of a diametrically opposed pair of the longitudinal struts upon flexure of the stent. The flexure members may comprise first and second curved sections which are of a different size. At least one of the curved sections may comprise an arc of greater than about 180°.

Expandable stent and method for delivery of same

A stent in the form of a thin-walled, multi-cellular tubular structure is provided. The tubular structure has a longitudinal axis and the stent includes a plurality of circumferential sets of strut members. Each set of the strut members is longitudinally displaced from each other and connected to each other by longitudinally extending links. Each set of the strut members forms a closed and cylindrical portion of the stent. Further, each set of the strut members includes a plurality of connected curve sections and diagonal sections. The sets of the strut members further include end sets of strut members located at each end of the stent and central sets of strut members located between the end sets of the strut members. The diagonal sections of the end sets of the strut members have a center portion and two ends. At least one of the diagonal sections of the end sets of the strut members includes a tapered shape with width of one diagonal section is greater at the center of the diagonal section than the width at either end of the diagonal section.

Stent with optimal strength and radiopacity characteristics

The present invention uses sets of strut members where the most distal set of strut members is similar to that of most stents in that the plane of the distal set of strut members is perpendicular to the stent's longitudinal axis The present invention has a multiplicity of circumferential sets of strut members, but only the distal set of strut members has its plane perpendicular to the stent's longitudinal axis The more proximal sets of strut members are angulated, so that the plane of the most proximal set of strut members has a preset angle such as 30°, 45° or 60° relative to the stent's longitudinal axis The stent could also be formed from or coated with a highly radiopaque material Alternately, a radiopaque marker could be placed at the most proximal point of the angulated, side branch stent, for the stent has to be rotated by the clinician until the plane of the most proximal angulated set of strut members is situated to be approximately parallel to the plane of the ostium of the side branch It is also envisioned to widen the diagonal sections of the most proximal circumferential set of strut members to increase their radiopacity as compared to the radiopacity of the more distal circumferential sets of strut members This can assist the clinician who places the side branch stent to have it properly placed at the ostium of the side branch

Stent with angulated struts

Disclosed herein is a thin-walled cylindrical stent in which one or more of the sets of strut members are more radially rigid after stent expansion as compared to other sets of strut members. Each set of strut members consists of a multiplicity of structural struts that are connected together with the struts extending circumferentially when the stent is outwardly radially deployed within a vessel of a human body. The sets of strut members are those parts of the stent which unfold during radial expansion and provide the radially rigid structure which maintains vessel patency. This invention is a stent structure specifically designed to have enhanced radial rigidity either at the ends or the center of the stent. More radially rigid end struts reduce injury to the vessel from over expansion at the ends of the stent. The embodiment of the present invention with enhanced rigidity in the center would be particularly useful for the treatment of calcified obstructions. Enhanced rigidity can be achieved by either having a set of strut members that becomes more ring-like when radially deployed, or the strut members have a greater width as compared to other strut members of the stent.

Intravascular stent with enhanced rigidity strut members

A balloon expandable metal stent is provided that includes a multiplicity of circumferential sets of strut members wherein at least two adjacent circumferential sets of strut members are coupled together by a plurality of undulating longitudinal struts. The stent is annealed to a degree where frictional forces existing in the longitudinal direction between adjacent circumferential sets of strut members and the balloon, during inflation, are greater than a force required to permanently deform the undulating longitudinal struts. Thus, the expansion of the space between adjacent circumferential sets of strut members during inflation of the balloon compensates for shortening of the stent that would otherwise occur during radial expansion of the stent responsive to the inflation of the balloon. The undulating longitudinal struts also have a width dimension throughout their length which is less than a width dimension of the circumferential sets of strut members to further facilitate the deformation of the undulating longitudinal struts when the balloon is inflated.

Stent with reduced shortening

Disclosed is a stent that has flexible connecting links that have a strut width as measured in a direction that is generally along the surface of the stent that is smaller than the wall thickness of the stent as measured in a radial direction from the stent's longitudinal axis. The strut width for a coronary stent should be less than 0.10 mm to provide good flexibility while the wall thickness should be greater than 0.10 mm to provide good stent radiopacity. Ideally the ratio of the width to the thickness should be less than 1.0 and preferably less than 0.08 mm and the nominal wall thickness would typically be 0.12 mm. The combination of thin strut width and thick wall thickness will allow the flexible link to easily lengthen and shorten for increased stent flexibility while making the link relatively stiff with respect to bulging inward into the lumen of the stent. This stiffness enhances the ability of the link to push outward against plaque in a coronary artery after the stent is deployed. In addition to improved flexibility, the thin width of the flexible links allow them to stretch during stent expansion thus reducing foreshortening of the deployed stent.

Stent with improved flexible connecting links

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