WO2009105699A1 - Design and method of placement of a graft or graft system - Google Patents
Design and method of placement of a graft or graft system Download PDFInfo
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- WO2009105699A1 WO2009105699A1 PCT/US2009/034755 US2009034755W WO2009105699A1 WO 2009105699 A1 WO2009105699 A1 WO 2009105699A1 US 2009034755 W US2009034755 W US 2009034755W WO 2009105699 A1 WO2009105699 A1 WO 2009105699A1
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- branch
- graft
- main graft
- opening
- endoluminal prosthesis
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/95—Instruments specially adapted for placement or removal of stents or stent-grafts
- A61F2/954—Instruments specially adapted for placement or removal of stents or stent-grafts for placing stents or stent-grafts in a bifurcation
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/04—Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
- A61F2/06—Blood vessels
- A61F2/07—Stent-grafts
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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Definitions
- the present invention relates to endoluminal vascular prostheses and methods of placing such prostheses, and, in one application, to endoluminal vascular prostheses for use in the treatment of vessels with branches.
- An abdominal aortic aneurysm is a sac caused by an abnormal dilation of the wall of the aorta, a major artery of the body, as it passes through the abdomen.
- the abdomen is that portion of the body which lies between the thorax and the pelvis. It contains a cavity, known as the abdominal cavity, separated by the diaphragm from the thoracic cavity and lined with a serous membrane, the peritoneum.
- the aorta is the main trunk, or artery, from which the systemic arterial system proceeds. It arises from the left ventricle of the heart, passes upward, bends over and passes down through the thorax and through the abdomen to about the level of the fourth lumbar vertebra, where it divides into the two common iliac arteries.
- the aneurysm usually arises in the infrarenal portion of the diseased aorta, for example, below the kidneys. When left untreated, the aneurysm may eventually cause rupture of the sac with ensuing fatal hemorrhaging in a very short time. High mortality associated with the rupture led initially to transabdominal surgical repair of abdominal aortic aneurysms. Surgery involving the abdominal wall, however, is a major undertaking with associated high risks.
- a prosthetic device typically is a synthetic tube, or graft, usually fabricated of polyester, urethane, Dacron.RTM., Tefion.RTM., or other suitable material.
- aorta To perform the surgical procedure requires exposure of the aorta through an abdominal incision which can extend from the rib cage to the pubis.
- the aorta must typically be closed both above and below the aneurysm, so that the aneurysm can then be opened and the thrombus, or blood clot, and arteriosclerotic debris removed.
- Small arterial branches from the back wall of the aorta are tied off.
- the Dacron.RTM. tube, or graft of approximately the same size of the normal aorta is sutured in place, thereby replacing the aneurysm. Blood flow is then reestablished through the graft. It is necessary to move the intestines in order to get to the back wall of the abdomen prior to clamping off the aorta.
- the survival rate of treated patients is markedly higher than if the surgery is performed after the aneurysm ruptures, although the mortality rate is still quite high. If the surgery is performed prior to the aneurysm rupturing, the mortality rate is typically slightly less than 10%. Conventional surgery performed after the rupture of the aneurysm is significantly higher, one study reporting a mortality rate of 66.5%. Although abdominal aortic aneurysms can be detected from routine examinations, the patient does not experience any pain from the condition. Thus, if the patient is not receiving routine examinations, it is possible that the aneurysm will progress to the rupture stage, wherein the mortality rates are significantly higher.
- Disadvantages associated with the conventional, prior art surgery, in addition to the high mortality rate include the extended recovery period associated with such surgery: difficulties in suturing the graft, or tube, to the aorta; the loss of the existing aorta wall and thrombosis to support and reinforce the graft; the unsuitability of the surgery for many patients having abdominal aortic aneurysms; and the problems associated with performing the surgery on an emergency basis after the aneurysm has ruptured.
- a patient can expect to spend from one to two weeks in the hospital after the surgery, a major portion of which is spent in the intensive care unit, and a convalescence period at home from two to three months, particularly if the patient has other illnesses such as heart, lung, liver, and/or kidney disease, in which case the hospital stay is also lengthened. Since the graft must typically be secured, or sutured, to the remaining portion of the aorta, it is many times difficult to perform the suturing step because the thrombosis present on the remaining portion of the aorta, and that remaining portion of the aorta wall may many times be friable, or easily crumbled.
- Parodi, et al. provide one of the first clinical descriptions of this therapy.
- Parodi, J. C, et al. "Transfemoral Intraluminal Graft Implantation for Abdominal Aortic Aneurysms," 5 Annals of Vascular Surgery 491 (1991).
- Endovascular grafting involves the transluminal placement of a prosthetic arterial graft in the endoluminal position (within the lumen of the artery).
- the graft is attached to the internal surface of an arterial wall by means of attachment devices (expandable stents), typically one above the aneurysm and a second stent below the aneurysm.
- Stents can permit fixation of a graft to the internal surface of an arterial wall without sewing or an open surgical procedure. Expansion of radially expandable stents is conventionally accomplished by dilating a balloon at the distal end of a balloon catheter.
- Palmaz describes a balloon-expandable stent for endovascular treatments.
- self-expanding stents such as described in U.S. Pat. No. 4,655,771 to Wallsten.
- the diseased region of the blood vessels extends across branch vessels.
- the blood flow into these branch vessels is critical for the perfusion of the peripheral regions of the body and vital organs.
- Many arteries branch off the aorta.
- the carotid arteries supply blood into the brain
- the renal arteries supply blood into the kidneys
- the superior mesenteric artery (“SMA " ) supplies the pancreas
- hypogastric arteries to the reproductive organs
- the subclavian arteries supply blood to the arms.
- the branch vessels may also be affected.
- Thoracic aortic aneurysms may involve the subclavian and carotid arteries
- abdominal aneurysms may involve the SMA
- renal and hypogastric arteries may involve all branch vessels mentioned above.
- Some embodiments of the endoluminal prosthesis disclosed herein pertain to the design and method of placement of a branch graft system for endovascular treatment of diseased blood vessels.
- the branch graft system can comprise a tubular expandable main body and at least one branch graft.
- the branch graft is made from an expandable material, which can be ePTFE.
- the diameter of the branch graft can be sufficiently small to be manipulated into the desired vascular position by moving the branch graft over a guidewire.
- the branch graft can be expanded to the diameter of the branch vessel by mechanical means, which can be a dilation balloon.
- the main body of the branch graft system can have one large opening in the wall of the graft for the treatment of a second branch vessel.
- a second branch graft system can be placed inside of the first branch graft system, wherein the branch graft of the second branch graft system passed through the opening of the first branch graft system and the large opening of the second branch graft system overlaps with the branch graft of the first branch graft system.
- an endoluminal prosthesis system can comprise a first endoluminal prosthesis comprising a first main graft body having at least a first and a second opening therein and a second endoluminal prosthesis comprising a second main graft body having at least a first and a second opening therein.
- the first opening in the first main graft body can be smaller than the second opening in the first main graft body, and the first opening in the second main graft body can be smaller than the second opening in the second main graft body.
- the second main graft body can be configured to be expandable substantially within the first main graft body such that the second opening of the second main graft body does not cover any portion of the first opening in the first main graft body, and such that the second opening of the first main graft body does not cover any portion of the first opening in the second main graft body.
- the resulting endoluminal prosthesis system can have two small openings therein that are each approximately equivalent in diameter to the first opening in each of the first and second main graft bodies.
- a method of deploying a branch graft system in a portion of a patient's blood vessel having at least a first and a second branch blood vessel is described.
- the method can comprise positioning a first main graft body having at least a first and a second opening therein in the patient's blood vessel so that the first opening can be substantially aligned with the first branch blood vessel and so that the second opening can be sufficiently aligned with the second branch blood vessel so that the first main graft body does not substantially cover either the first or second branch blood vessel.
- the method can further comprise positioning at least a portion of a second main graft body having at least a first and a second opening therein within the inside of the first main graft body so that the first opening of the second main graft body can be substantially aligned with the second branch blood vessel and so that the second opening of the second main graft body can be sufficiently aligned with the first branch blood vessel so that the second main graft body does not substantially cover either the first or second branch blood vessel.
- the method can further comprise expanding the first and second main graft bodies against the patient ' s blood vessel to create a multi-layer graft system having two openings through the wall thereof that are substantially aligned with the first and second blood vessels and have a diameter substantially equal to the first opening of each of the first and second main graft bodies, and supporting the first and second main graft bodies against the patient " s blood vessel.
- the second opening in each of the first and second main graft bodies can be substantially larger than the first opening in each of the first and second main graft bodies.
- an endoluminal prosthesis can comprise an expandable main graft portion having an axial opening therethrough and at least a first branch opening therein and an expandable branch graft portion having a proximal end portion, a distal end portion, and an axial opening therethrough.
- the branch graft portion can be supported by the main graft portion and the branch graft portion can be supported by the main graft portion so that the proximal end portion of the branch graft portion can be positioned around a periphery of the first branch opening in the main graft, and such that the axial opening through the branch graft portion can be in communication with the first branch opening formed in the main graft portion.
- At least the distal end portion of the branch graft portion can be in a first, unexpanded state.
- the distal end portion of the branch graft portion before the branch graft has been deployed in the desired vascular location, can have a diameter that is less than the diameter of the proximal end portion of the branch graft portion.
- FIG. 1A is a perspective view of an embodiment of an endoluminal prosthesis.
- Figure IB is a perspective view of the main body graft of the embodiment of the endoluminal prosthesis illustrated in Figure IA.
- Figure 1C is a perspective view of the partially expanded branch graft of the embodiment of the endoluminal prosthesis illustrated in Figure IA.
- Figure ID is a perspective view of the branch graft illustrated in Figure IB before the branch graft 14 has been partially expanded.
- Figure IE is a partial section view of the branch graft illustrated in Figure ID, wherein a portion of the branch graft has been partially expanded with the use of the balloon expander.
- Figure 2 is a partial section view of a portion of the embodiment of the endoluminal prosthesis illustrated in Figure IA, after the branch graft portion of the endoluminal prosthesis has been positioned within a branch artery.
- Figure 3 is a partial section view of a portion of the embodiment of the endoluminal prosthesis illustrated in Figure IA, showing a balloon expandable stent being positioned within the partially expanded branch graft of the endoluminal prosthesis.
- Figure 4 is a partial section view of a portion of the embodiment of the endoluminal prosthesis illustrated in Figure IA, showing a balloon expandable stent being expanded within the branch graft of the endoluminal prosthesis.
- Figure 5 is a partial section view of a portion of the embodiment of the endoluminal prosthesis illustrated in Figure IA, showing an expanded stent positioned within a branch graft of the endoluminal prosthesis.
- Figure 6 is a graphical illustration of the location of the two renal arteries with respect to the superior mesenteric artery ("SMA " ) in 50 patients undergoing an abdominal aortic aneurysm C'AAA”) procedure.
- Figures 7A and 7B are a front view and a section view, respectively, of another embodiment of an endoluminal prosthesis.
- Figures 8A, 8B, and 8C are a perspective view, top view, and section view, respectively, of yet another embodiment of an endoluminal prosthesis.
- Figures 9A and 9B are a perspective view and a side view, respectively, of an embodiment of a fenestrated endoluminal prosthesis.
- Figures 1 OA and 1 OB are a perspective view and a side view, respectively, of another embodiment of a fenestrated endoluminal prosthesis.
- Figures 1 IA and 1 IB are a perspective view and a side view, respectively, of another embodiment of a fenestrated endoluminal prosthesis.
- Figure 12 is a partial section view of the endoluminal prosthesis illustrated in Figures 1OA, 1OB positioned within an embodiment of a delivery catheter.
- Figure 13 is a side view of the embodiment of the endoluminal prosthesis illustrated in Figures 1OA. 1 OB before the endoluminal prosthesis is placed in a delivery catheter.
- Figure 13 is a partial section view of the embodiment of the endoluminal prosthesis illustrated in Figure 1OA after the outer sheath of the delivery catheter illustrated in Figure 12 has been retracted.
- Figure 14 is a partial section view of a patient's vasculature illustrating guidewires inserted through the abdominal aortic and into the renal arteries.
- Figure 15 is a perspective view of the embodiment of the endoluminal prosthesis illustrated in Figures 1 OA, 1 OB in the deployed or expanded state.
- Figure 16 is a partial section view of a patient's vasculature illustrating the endoluminal prosthesis illustrated in Figures 1OA, 1OB deployed in the desired position within the patient's vasculature, after the components of the delivery system except for the guidewires have been retracted from the patient's vasculature.
- Figure 17 is a partial section view of a patient's vasculature illustrating the endoluminal prosthesis illustrated in Figures 1OA, 1OB deployed in the desired position within the patient's vasculature, after all of the components of the delivery system have been retracted from the patient's vasculature.
- Figure 18 is a partial section view of a patient's vasculature illustrating the endoluminal prosthesis illustrated in Figures 1 IA, 1 IB also deployed in the desired position within the patient's vasculature, after the components of the delivery system except for the guidewires have been retracted from the patient's vasculature.
- Figure 19 is a partial section view of a patient's vasculature illustrating both endoluminal prostheses positioned in the desired position within the patient's vasculature, after the components of the delivery system have been retracted from the patient's vasculature.
- Figure 20 is a perspective view of another embodiment of an endoluminal prosthesis with a scalloped end portion.
- Figure 21 is a perspective view of another embodiment of an endoluminal prosthesis with a large opening open to the proximal end of the graft.
- Figure 22 is a partial section view of a patient's vasculature illustrating two of the endoluminal prostheses illustrated in Figure 21 deployed in the desired position within the patient's vasculature, after the components of the delivery system except for the hollow guidewires have been retracted from the patient's vasculature.
- Figures 23 and 24 are partial section views of a patient's vasculature illustrating two of the endoluminal prostheses illustrated in Figure 21 deployed in the desired position within the patient's vasculature, further illustrating a branch graft deployment catheter being guided into the right renal artery over a guidewire.
- Figure 25 is a partial section view of a patient's vasculature illustrating an embodiment of a stent being deployed in the branch graft positioned in a patient's right renal artery.
- Figure 26 is a partial section view of a patient's vasculature illustrating an embodiment of a stent after it has been deployed in the branch graft positioned in a patient's right renal artery.
- Figure 27 is a partial section view of a patient's vasculature illustrating an embodiment of a stent after it has been deployed in the branch graft positioned in a patient's right renal artery, further illustrating the delivery catheter being removed from the patient's vasculature.
- Certain embodiments described herein are directed to systems, methods, and apparatuses to treat lesions, aneurysms, or other defects in the aorta, including, but not limited to, the thoracic, ascending, and abdominal aorta, to name a few.
- the systems, methods, and apparatuses may have application to other vessels or areas of the body, or to other fields, and such additional applications are intended to form a part of this disclosure.
- the systems, methods, and apparatuses may have application to the treatment of blood vessels in animals.
- the embodiments and/or aspects of the endoluminal prosthesis systems, methods, and apparatuses described herein can be applied to other parts of the body or may have other applications apart from the treatment of the thoracic, ascending, and abdominal aorta.
- specific embodiments may be described herein with regard to particular portions of the aorta, it is to be understood that the embodiments described can be adapted for use in other portions of the aorta or other portions of the body and are not limited to the aortic portions described.
- Figure IA is a perspective view of an embodiment of an endoluminal prosthesis 10 (also sometimes referred to herein as a branch graft system) having a main body graft 12 and at least one branch graft 14.
- the branch graft 14 is shown in a partially expanded state.
- the main body graft 12 can be positioned in the abdominal aorta, which the branch graft or grafts 14 can be positioned within the left or right renal artery.
- the branch graft or grafts 14 can be positioned within any one or combination of the following: left renal artery, right renal artery, second lumbar, testicular, inferior mesenteric, middle sacral, or other vessels branching from the aorta.
- the endoluminal prosthesis 10 can comprise any number of branch grafts 14 that are required for the specific application, including, but not limited to, two, three, or more branch grafts 14.
- the branch graft or grafts 14 can be configured to confonn to a wide range of vessels and a wide range of positions, the branch graft or grafts 14 can be of any suitable size, shape, or configuration, and can be attached to the main body graft 12 in any of a wide variety of locations. Therefore, some embodiments of the endoluminal prosthesis 10 can comprise only one branch graft 14. However, in some embodiments, the endoluminal prosthesis 10 can comprise two or more branch grafts 14, or any suitable number depending on the application.
- Figure IB is a perspective view of the main body graft 12 of the embodiment of the endoluminal prosthesis 10 illustrated in Figure IA.
- Figure 1C is a perspective view of the partially expanded branch graft 14 of the embodiment of the endoluminal prosthesis 10 illustrated in Figure IA.
- Figure 1C illustrates the branch graft 14 before it has been assembled with the main body graft 12 to form the embodiment of the endoluminal prosthesis 10 illustrated in Figure IA.
- Figure ID is a perspective view of the branch graft 14 illustrated in Figure IB before the branch graft 14 has been partially expanded.
- Figure 1 E is a partial section view of the branch graft illustrated in Figure 1 D, wherein a portion of the branch graft 14 has been partially expanded with the use of the balloon expander 16.
- the branch graft 14 in the pre-expanded state as shown in Figure ID can be partially expanded by the balloon expander 16 to form the partially expanded branch graft 14 shown in Figures IA, 1C.
- the proximal end portion 14a of the branch graft 14 i.e., the end of the branch graft 14 closest to opening 14b
- the balloon expander 16 can preferably be expanded by the balloon expander 16.
- the balloon expander 16 can be partially inserted into the proximal end portion 14a of the pre-expanded branch graft 14 (shown in Figure ID) and inflated until the proximal end portion 14a of the branch graft 14 reaches the desired or suitable size. While the expansion being of the branch graft 14 can be performed with a balloon expander 16, as is illustrated in Figure IE, any suitable method of expanding the branch graft 14 can be employed, including but without limitation other forms of mechanical expanders. Thus, Figure IE illustrates only one of several suitable methods for partially expanding the pre-expanded branch graft 14 illustrated in Figure ID to form the partially expanded branch graft 14 illustrated in Figure IA, 1C.
- the proximal end portion 14a of the branch graft 14 can be expanded to approximately match or conform to the expected diameter of the branch vessel and/or the diameter of the opening 12a.
- the branch graft 14 can be configured so as to be expandable over a wide range of sizes and cross-sectional shapes, depending on the size or shape of the branch vessel that the branch graft 14 is intended to be supported by.
- the proximal portion of the partially expanded branch graft 14 can be trimmed to conform to the opening 12a formed in the main body graft 12.
- the opening 12a can be sized and positioned to conform to the desired size location of the partially expanded branch graft 14.
- the branch graft 14 can be attached to the main body graft 12 using adhesive, sutures, or any other suitable attachment method, to form the endoluminal prosthesis 10 illustrated in Figure IA.
- Any portion of the endoluminal prosthesis 10, including the main body graft 12 and/or the branch graft 14, or any other endoluminal prosthesis disclosed herein can be formed from PTFE, ePTFE, polyester, urethane, Dacron, Dacron.RTM., Teflon.RTM., or any other distensible polymeric material or other suitable material.
- the sutures used to attach the branch graft 14 (or any other branch graft disclosed herein) to the main body 12 (or any other main body or graft portion disclosed herein) can be made from a radiopaque ("RO") material so that the location of the branch graft can be perceived in an x-ray or other radiation transmission during deployment, hi some embodiments, the sutures can be made from platinum, gold, barium sulfate, or any other suitable RO material.
- RO radiopaque
- RO markers can be sewn to or otherwise attached to the main body of the endoluminal prosthesis at any suitable position, such as but not limited to adjacent to or on the branch graft or near the end portions of the main body, again to aid in visualization of the endoluminal prosthesis during deployment.
- the diameter of the pre-expanded branch graft 14 can be from approximately 1 mm or less to approximately 3 mm or more.
- the pre-expanded diameter of the pre-expanded branch graft 14 can be any suitable cross-sectional size or shape depending on the size and shape of the target artery or blood vessel.
- the shape of the pre-expanded branch graft 14 can be cylindrical.
- the shape of the pre- expanded branch graft 14 is not so limited.
- the pre-expanded branch graft 14 can define a curved, angled, tapered or other suitable shape.
- the branch graft 14 can be integrally formed with the main body graft 12.
- the branch graft 14 can be attached to the main body graft 12 using sutures, adhesive, or any other suitable attachment material or method.
- the junction between the branch graft or grafts 14 and the main body graft 12 can be sealed so as to substantially inhibit or prevent blood from leaking through the junction and flowing between the main body graft 12 and the aorta or other blood vessel that the main body graft 12 is positioned within.
- the junction between the branch graft or grafts 14 and the main body graft 12 can be sealed so as to inhibit or prevent at least the majority of the blood flowing therethrough from leaking through the junction and flowing between the main body graft 12 and the aorta or other blood vessel that the main body graft 12 is positioned within.
- the endoluminal prosthesis 10 can be less susceptible to leakage between the main body graft 12 and the aorta or blood vessel at the blood vessel branch point as compared to conventional fenestrated graft systems.
- the main body graft 12 or the branch graft 14 of the endoluminal prosthesis 10 can be similar in size, material, or other details to other suitable expandable bifurcated or non-bifurcated endoluminal prostheses presently known or later developed in the art, or can be of any size, material, or other details of any other prosthesis presently known or later developed in the art.
- the main body graft 12 or the branch graft 14 can comprise any of the materials, features, or other aspects of the embodiments of the polymeric sleeves or the tubular wire supports disclosed in U.S. Patent No.
- the main body graft 12 and/or the branch graft 14 can be expanded using an uncovered (i.e., bare) self-expanding metal frame or a self-expanding metal frame covered with a thin graft material, which can be made from ePTFE, as disclosed in U.S. Patent No. 6,077,296.
- a thin graft material which can be made from ePTFE, as disclosed in U.S. Patent No. 6,077,296.
- the specific design and selection of the materials, shapes, or other aspects for the main body graft 12 or the branch graft 14 of the endoluminal prosthesis 10 is not limited to the designs and configurations disclosed or incorporated by reference herein, but can be based on any suitable variety of materials, shapes, or other aspects of any other suitable endoluminal prostheses.
- main body graft 12 and/or the branch graft 14 can be expanded using a mechanical expander, and be held in the expanded position against the blood vessel wall by the blood pressure within the vessel (i.e., without the use of a stent).
- the main body graft 12 can comprise an expandable metal frame to support the main body graft 12 within the aorta (not illustrated).
- the frame supporting the main body graft 12 of the endoluminal prosthesis 10 can be fo ⁇ ned from a metal or any other suitable material, and can be configured so as to not obstruct the flow of blood through the opening 14b in the branch graft or grafts 14.
- the metal frame can comprise a self-expandable structure comprising one or more wires forming a zig-zag, tubular shape, as described above with reference to U.S. Patent Nos.
- the metal frame can be formed by laser cutting a tubular structure. Such structures are well known in the art. However, those of skill in the art will recognize that various configurations and constructions of the frame can be used in light of the disclosure herein.
- Figure 2 is a partial section view of a portion of the embodiment of the endoluminal prosthesis 10 illustrated in Figure IA, after the branch graft portion 14 of the endoluminal prosthesis 10 has been positioned within a branch vessel artery (represented by BV in Figure 2).
- Figure 3 is a partial section view of a portion of the embodiment of the endoluminal prosthesis 10 illustrated in Figure IA, showing a balloon expandable stent being positioned within the partially expanded branch graft 14 of the endoluminal prosthesis 10.
- Figure 4 is a partial section view of a portion of the embodiment of the endoluminal prosthesis 10 illustrated in Figure IA, showing a balloon expandable stent being expanded within the branch graft 14 of the endoluminal prosthesis 10.
- Figure 5 is a partial section view of a portion of the embodiment of the endoluminal prosthesis 10 illustrated in Figure IA, showing an expanded stent positioned within a branch graft 14 of the endoluminal prosthesis 10.
- a balloon-expandable stent 20 can be guided over the guidewire 18 and positioned inside the partially expanded branch graft 14.
- the balloon expandable stent 20 can be expanded by the expansion of a balloon 22 positioned within the balloon expandable stent 20.
- a balloon 22 can be deflated, leaving the expanded stent 20 positioned within the branch graft 14, as illustrated in Figure 5.
- the main body graft 12 and/or branch graft 14 the can be expanded and secured in the desired position by any other suitable method for such.
- Suitable expansion apparatuses and methods include, but are not limited to, balloon catheters, dilators, and self- expanding stents or stent grafts.
- Other means of securing the main body graft 12 and/or branch graft 14 may include, without limitation, self-expanding stents, stent grafts, sutures, and staples.
- the stent 20 can be a bare wire stent of any configuration described above or incorporated herein by reference.
- the stent 20 can be a graft covered stent, also of any configuration described above or incorporated herein by reference.
- a graft covered stent can provide a greater degree of safety to the patient by providing a double layer graft system that can be less prone to tearing or other damage.
- the main body graft 12 may thereafter be expanded within the aorta, hi some arrangements, the main body graft 12 can be expanded within the aorta prior to expanding the branch stent 14 within the branch vessel BV.
- the main body graft 12 can be expanded and held in the desired position using a self- expandable stent, or can be expanded and held in position by any other suitable stent device, such as without limitation, a balloon expandable stent.
- the main body graft 12 can be expanded and held in position with a bare metal stent or a covered stent, or any of the stents described or incorporated by reference herein.
- Some embodiments of the endoluminal prosthesis 10 can be implanted within the desired vessel in a multistep process, such that an integrated deployment mechanism is not used for such embodiments of the endoluminal prosthesis 10.
- the expansion and stenting of the branch graft 14 can be performed in a secondary procedure, after the branch graft 14 has been positioned in the desired blood vessel.
- the endoluminal prosthesis 10 can be formed with multiple branch grafts 14 formed therein or secured thereto.
- the two renal arteries and the superior mesenteric artery generally branch off from the aorta in close proximity to each other.
- the positions of the branch vessels generally vary from patient to patient, as shown in Figure 6, which is a graphical illustration of the location of the two renal arteries with respect to the SMA in 50 patients undergoing an abdominal aortic aneurysm (AAA) procedure.
- the SMA is located at the origin of the graph.
- the locations of the left and right renal arteries are expressed in terms of axial distance from the SMA in millimeters (x-axis), and circumferential angle from the SMA (y-axis).
- x-axis millimeters
- y-axis circumferential angle from the SMA
- Figure 6 indicates that, in case of stent grafting across the renal arteries, the small and the large opening are approximately 180 degrees opposite to each other.
- the large opening can be sufficiently large to accommodate an axial distance between the renal arteries of between approximately 15 mm and approximately 20 mm, and a circumferential asymmetry of +/- 20 degrees.
- the large opening may have a diameter of approximately 20 mm.
- Figures 7A and 7B are a front view and a section view, respectively, of another embodiment of an endoluminal prosthesis 30 having a main body graft 32 and a branch graft 34.
- Figures 8A, 8B, and 8C are a perspective view, top view, and section view, respectively, of another embodiment of an endoluminal prosthesis 40 having a main body graft 42 and a branch graft 44.
- the embodiments of the endoluminal prostheses in Figures 7A-8B can be configured for application in portions of the body other than in the portions of the aorta described above.
- some embodiments of the endoluminal prosthesis 30 illustrated in Figures 7A, 7B can be configured for application in a specific artery or arteries.
- the embodiment of the endoluminal prosthesis 30 illustrated in Figures 7A, 7B can be configured for use in the thoracic aorta, with the branch graft 34 configured for positioning within the subclavian artery.
- the main body graft 32 can define curved portion that may be suitable for curved vessels such as that of the subclavian artery.
- Other aspects of the endoluminal prosthesis 30 can be the same as or similar to any of the other endoluminal prostheses disclosed herein, and the endoluminal prosthesis 30 can be deployed and secured in the desired artery by any of the same methods as described above with respect to endoluminal prosthesis 10.
- some embodiments of the endoluminal prostheses 40 illustrated in Figures 8A, 8B can also be configured for application in a specific artery or arteries.
- the embodiments of the endoluminal prosthesis 40 illustrated in Figures 8A, 8B can be configured for use in the iliac artery, with the branch graft 44 configured for positioning within the hypogastric artery or arteries.
- branch graft systems or endoluminal prostheses disclosed herein there are many locations in the body that would benefit from a placement of a branch graft systems or endoluminal prostheses disclosed herein to ensure perfusion of branch vessels, and none of the embodiments of the endoluminal prostheses disclosed herein are confined to any particular portion of the body.
- endoluminal prosthesis 40 can be the same as or similar to any of the other endoluminal prostheses disclosed herein, and the endoluminal prosthesis 40 can be deployed and secured in the desired artery by any of the same methods as described above with respect to endoluminal prosthesis 10.
- Figures 9A and 9B are a perspective view and a side view, respectively, of an embodiment of a fenestrated endoluminal prosthesis or graft 50.
- the fenestrated graft 50 can have two openings or fenestrations 52a, 52b formed in the main graft 50.
- fenestrated grafts 50 can be manufactured, each having a different location of the two openings or fenestrations 52a, 52b formed therein so that the doctor can select the appropriately configured fenestrated graft 50 depending on the patient's particular vasculature.
- Figures 1OA and 1OB are a perspective view and a side view, respectively, of an embodiment of a fenestrated endoluminal prosthesis 60 (also referred to herein as a first endoluminal prosthesis or graft), which present an alternative to the custom-made fenestrated grafts discussed above.
- a fenestrated endoluminal prosthesis 60 also referred to herein as a first endoluminal prosthesis or graft
- the placement of the fenestrated endoluminal prosthesis 60 at the renal arteries is described.
- the embodiments of the fenestrated endoluminal prostheses 60 disclosed herein are not limited to this particular location or application. This application merely serves as an example to illustrate the basic aspects of the fenestrated endoluminal prosthesis 60.
- the endoluminal prosthesis 60 can comprise a main body 62 and first and second openings 64, 66, respectively.
- the main body 62 can have an inside surface 62a and an outside surface 62b.
- the endoluminal prosthesis 60 can comprise any suitable or desired number of openings.
- the endoluminal prosthesis 60 can have one or more openings or cutouts (not illustrated) in addition to the openings 64, 66 illustrated in Figures 1OA, 1OB to account for other renal or branch arteries that may otherwise be covered by the main body 62 of the endoluminal prosthesis 60.
- the openings 64, 66 can be positioned at mutually or diametrically opposing locations. However, the openings 64, 66 can be positioned at any desired or suitable axial or radial position. Additionally, in the embodiment of the endoluminal prosthesis 60 illustrated in Figures 1OA, 1OB, the openings 64, 66 can have a circular shape. However, the openings 64, 66 can have any desired or suitable shape, including square, rectangular, polygonal, or otherwise.
- the diameter of the second opening 66 can be approximately four times greater than the diameter of the first opening 64. In some embodiments, the diameter of the second opening 66 can be between approximately two times greater and approximately four times greater, or between approximately four times greater and approximately six times or more greater than the diameter of the first opening 64. Additionally, in some embodiments, the second opening 66 can be configured to be as large as is possible to cover a wide range of branch vessel anatomies. As the size of the second opening 66 is increased, the potential to treat a large range of branch vessel anatomies is also increased.
- the width and/or height of the second opening 66 can be approximately four times greater than the width and/or height of the first opening 64. In some embodiments, the width and/or height of the second opening 66 can be between approximately two times greater and approximately four times greater, or between approximately four times greater and approximately six times or more greater than the width and/or height of the first opening 64.
- the prosthesis 60 can be self-expanding, balloon expandable, or can be of any other suitable configuration.
- the openings 64, 66 can be configured to be positioned adjacent to the two renal arteries.
- the first opening 64 can approximately match the size of the first renal artery, while the second opening 66 can be substantially larger that the first opening 64.
- the size of the second opening 66 can be greater than the size of the first opening 64 to account for the variability in the location of the second renal artery with respect to the first renal artery.
- the endoluminal prosthesis 60 can be positioned within the patient's vasculature so that the main body 62 of the endoluminal prosthesis 60 does not cover the second renal when the first opening 64 of the main body 62 is aligned with the patient's first renal artery.
- FIG. 1 IA and 1 IB are a perspective view and a side view, respectively, of the embodiment of the fenestrated endoluminal prosthesis 70.
- the main body 72 can have an inside surface 72a and an outside surface 72b.
- the first or smaller opening 74 of the second endoluminal prosthesis 70 can be positioned within the patient's vasculature so as to be aligned with the patient's second renal artery.
- the second or larger opening 76 of the second endoluminal prosthesis 70 can ensure that the first renal artery is not covered by the main body 72 of the second endoluminal prosthesis 70.
- the second, larger opening 66 in the first endoluminal prosthesis 60 and the second, larger opening 76 in the second endoluminal prosthesis 70 can allow for greater variability in the location of the renal arteries, without requiring a medical practitioner to custom make the prosthesis.
- the second endoluminal prosthesis 70 can be positioned within the patient's vasculature so that the first or smaller opening 74 is approximately aligned with the patient's second renal artery and the second or larger opening 76 is sufficiently aligned with the first renal artery so that the main body 72 does not cover the first renal artery.
- the second endoluminal prosthesis 70 can then be expanded so that the outside surface 72b of the main body 72 of the second endoluminal prosthesis 70 is in contact with the inside surface 62a of the main body 62 of the first endoluminal prosthesis 60.
- the second endoluminal prosthesis 70 can be the same as or similar to the first endoluminal prosthesis 60 including, but not limited to, having the same number, size, and location of the openings as are in the first endoluminal prosthesis 60.
- the second endoluminal prosthesis 70 can have a different configuration as compared to the first endoluminal prosthesis 60 including, but not limited to, having a different number, size, and/or location of the openings that are formed in the main body 72 of the second endoluminal prosthesis 70.
- the size and shape of the openings 64, 66, 74, 76 are not limited to the illustrations or the description set forth above, but can be any suitable size or shape, or can be positioned at any suitable location on the endoluminal prosthesis 60, 70, respectively. Additionally, the size, shape, or other aspects of the configuration of the endoluminal prostheses 60, 70 are not limited to the specific embodiments described or illustrated herein.
- the endoluminal prostheses 60, 70 can comprise any suitable size, shape, including openings or cutouts (i.e., scallops) formed in the proximal and/or distal ends thereof or other aspects of other suitable configurations known or later developed in the field including, but not limited to, other known expandable non-bifurcated and bifurcated prostheses.
- the main body 62, 72 of the prostheses 60, 70, respectively can comprise any of the materials, features, or other aspects of the embodiments of the endoluminal vascular prostheses disclosed in U.S. Patent Nos. 6,077,296, 6,187,036. 6,197,049, 6,500,202, 6,660,030 and/or 6,733,523, the entirety of which are hereby incorporated by reference as if fully set forth herein.
- the main body 62, 72 of the endoluminal prostheses 60, 70 may comprise any of the materials, shapes, or other aspects of the polymeric sleeves and/or the tubular wire supports disclosed in U.S. Patent Nos. 6,077,296, 6,187,036, 6,197,049, 6,500,202, 6,660,030 and/or 6,733,523.
- the specific design and selection of the materials, shapes, or other aspects for each of the main bodies 62, 72 of the endoluminal prostheses 60, 70 are not limited to those set forth in patents set forth above, but can be based on any suitable variety of materials, shapes, or other aspects of any other suitable endoluminal prostheses.
- Figure 12 is a partial section view of the endoluminal prosthesis 60 illustrated in Figures 1OA, 1OB positioned within an embodiment of a delivery catheter 78.
- Figure 13 is a side view of the embodiment of the endoluminal prosthesis 60 illustrated in Figures 1OA, 1OB before the endoluminal prosthesis 60 is placed in a delivery catheter 78.
- the hollow guidewires 80, 82 can be placed through the openings 64, 66, respectively, of the endoluminal prosthesis 60.
- the guidewires 80, 82 can be made from a plastic extrusion or metal braids.
- the hollow guidewires 80, 82 can be made from braided Nitinol wire.
- the outer diameter of the guidewires 80, 82 can be approximately 0.035in and the lumen of the guidewire can be approximately 0.016in to accommodate a second 0.014 in guidewire.
- the guidewires 80, 82 can be configured to pass over a 0.018in or any other suitable guidewire.
- Figure 14 is a partial section view of a patient's vasculature illustrating guidewires 90, 92 inserted through the abdominal aortic 94 and into the renal arteries 96, 98, respectively.
- the guidewires 80, 82 can support balloons on the distal end of the guidewires 80, 82.
- the balloons can be inflated in the branch vessel to removably anchor or support the guidewire 80, 82 against the vessel wall and prevent inadvertent removal of the guidewires from the branch vessels during the deployment procedure.
- one or more occlusion balloon catheters can be used.
- Other anchoring mechanisms can be attached to the guidewire, such as, without limitation, hooks, to removably secure one or more of the guidewires 80, 82 within or to the vessel.
- one of more of the guidewires disclosed herein can have a coiled distal end portion.
- the coiled distal end portion can be configured to be insertable into a branch vessel and can be biased to remain in the branch vessel.
- the size or diameter of the coils can be greater than the inside diameter of the branch vessel so as to bias the coiled portion to remain within the branch vessel when the proximal end of the guidewire is retracted.
- proximal retraction of the guidewire can cause a proximal end of the coil to unravel, allowing a portion of the coiled portion of the guidewire to be unraveled and retracted while the remaining portion of the coiled portion can remain within the branch vessel.
- This configuration can inhibit the distal end portion of the guidewire from being inadvertently removed from the branch vessel.
- the guidewire can be retracted until the entire coiled portion is unraveled and retracted.
- the length of the coiled portion can be approximately 6 cm. In some embodiments, the length of the coiled portion can be between approximately 3 cm or less and approximately 5 cm, or between approximately 5 cm and approximately 7 cm, or between approximately 7 cm and approximately 9 cm or more, or from or to any values in these ranges. In some embodiments, the unraveled length of the coiled portion can be approximately 20 cm. In some embodiments, the unraveled length of the coiled portion can be between approximately 10 cm or less and approximately 15 cm, or between approximately 15 cm and approximately 20 cm, or between approximately 20 cm and approximately 25 cm or more, or from or to any values in these ranges.
- the guidewires 80, 82 or any other guidewires disclosed herein can have any desired or suitable configuration.
- the guidewires 80, 82 or any other guidewires disclosed herein can have the same or similar materials, configurations, methods of fabrication, and other aspects or details as the hollow guidewires set forth in U.S. Patent Application Publication No. US 2004-0098087 Al, titled DUAL WIRE PLACEMENT CATHETER (Application No. 10/706,660), filed on November 12, 2003, and U.S. Application No. 11/623,022, titled DUAL CONCENTRIC GUIDEWIRE AND METHODS OF BIFURCATED GRAFT DEPLOYMENT, filed on January 12, 2007, the entirety of both of which are incorporated by reference herein as if fully set forth herein.
- the collapsed endoluminal prosthesis 60 can be supported within the outer sheath 84 of the delivery catheter 78 in the space between the catheter shaft 86 and the catheter tip 88.
- the hollow guidewires 80, 82 can slide through openings or lumens in the catheter shaft 86.
- the hollow guidewires 80, 82 can be fixed to the catheter shaft 86.
- the hollow guidewires 80, 82 can pass through the outer sheath 84 from the proximal end of the delivery catheter 78 to the distal end of the delivery catheter 78.
- Each of the hollow guidewires 80, 82 can be configured to receive or allow the insertion of 0.014 in guidewire therethrough. In this configuration, the hollow guidewires 80, 82 can pass over guidewires 90, 92 that can be pre-placed in the appropriate vasculature.
- the endoluminal prosthesis 60 can be retained in the delivery catheter 78 by the outer sheath 84. As will be described in greater detail, retraction of the outer sheath 84 can deploy the endoluminal prosthesis 60. With the outer sheath 84 retracted, the endoluminal prosthesis 60 can expand either by self-expansion, balloon expansion, or by any other suitable method or mechanism.
- Figure 15 is a perspective view of the embodiment of the endoluminal prosthesis 60 illustrated in Figures 1OA, 1OB in the deployed or expanded state (i.e., after the outer sheath 84 of the catheter 78 has been retracted and of the endoluminal prosthesis 60 has been expanded).
- Figure 15 also shows the guidewires 80, 82 passing through the openings 64, 66 respectively.
- the catheter 78 can have three lumens through at least a portion of the catheter 78, each of the three lumens configured to receive a guidewire. Having three lumens through at least a portion of the catheter 78 can prevent twisting of the guidewires, so as to ensure proper deployment.
- each of the 0.014 in guidewires 90, 92 can be passed through the hollow guidewires 80, 82, respectively. Therefore, before placing the endoluminal prosthesis 60 across the renal arteries, the guidewires 90, 92 can be maneuvered into the target vessels, as shown in Figure 14, which is a partial section view of a patient's vasculature illustrating guidewires 90, 92 inserted through the abdominal aortic 94 and into the renal arteries 96, 98, respectively.
- third guidewire 100 can be positioned in the aorta 94 at the same time that the 0.014 in guidewires 90, 92 can be placed in the left and the right renal arteries 96, 98, respectively.
- the delivery catheter 78 can then be passed over guidewire 100 into the aorta.
- the hollow guidewires 80, 82 of the delivery system can track over the guidewires 90, 92 into the renal arteries until the endoluminal prosthesis 60 is positioned in the desired location.
- Figure 16 is a partial section view of a patient's vasculature illustrating the endoluminal prosthesis 60 deployed in the desired position within the patient's vasculature, after the components of the delivery catheter 78 except for the guidewires 80, 82 have been retracted from the patient's vasculature.
- the hollow guidewire 80 can pass over the guidewire 90 through the opening 64 into the right renal artery 98.
- the hollow guidewire 82 can pass over the guidewire 92 through the opening 66 into the left renal artery 96.
- sutures or markers made from an RO material can be sewn into or attached to the endoluminal prosthesis 60 or any other prosthesis disclosed herein adjacent to the openings formed therein or at any other suitable location to assist the medical practitioner in visualizing the location of the prosthesis relative to the patient ' s vasculature.
- RO sutures can be sewn into the main body 62 of the endoluminal prosthesis 60 around each of the openings 64, 66 and/or near the end portion or portions of the main body 62.
- RO markers can be sewn to or otherwise attached to the main body of the endoluminal prosthesis 60 or any endoluminal prosthesis at any suitable position.
- Figure 17 is a partial section view of a patient's vasculature illustrating the endoluminal prosthesis 60 illustrated in Figures 1OA, 1OB deployed in the desired position within the patient's vasculature, after all of the components of the delivery catheter 78 have been retracted from the patient's vasculature, including the hollow guidewires 80, 82.
- the guidewires 90, 92 can remain in position in the renal arteries.
- the first, smaller opening 64 of the endoluminal prosthesis 60 can be approximately aligned with the right renal artery 98. As mentioned, the first opening 64 can approximately match the size of the opening into the right renal artery 98.
- the second, larger opening 66 of the endoluminal prosthesis 60 can be positioned so that the main body 62 of the endoluminal prosthesis 60 does not cover or inhibit the flow of blood from the aortic artery 94 into the left renal artery 96.
- Figure 18 is a partial section view of a patient's vasculature illustrating the endoluminal prosthesis 70 illustrated in Figures HA, HB also deployed in the desired position within the patient's vasculature, after the components of the delivery system except for the guidewires have been retracted from the patient's vasculature.
- a second endoluminal prosthesis 70 has been positioned in the desired location in a similar fashion as has been described above with respect to the first endoluminal prosthesis 60. Again the hollow guidewires 102, 104 of the second delivery system can pass over the guidewires 90, 92, respectively.
- the opening 74 (which, again, can be relatively small as compared to opening 76) in the second endoluminal prosthesis 70 can be placed adjacent to the left renal artery 96.
- the opening 76 (which can be relatively large as compared to the first opening 74) in the second endoluminal prosthesis 70 can be placed adjacent to the right renal artery 98.
- Figure 19 is a partial section view of a patient's vasculature illustrating both endoluminal prostheses 60, 70 positioned in the desired position within the patient's vasculature, after the components of the delivery system or systems have been retracted from the patient's vasculature.
- the small openings 64, 74 of the respective endoluminal prostheses 60, 70 provide fenestration to both renal arteries 98, 96, respectively.
- the overlapping endoluminal prostheses 60, 70 ensure a seal of the graft against the aorta.
- an expandable stent can be positioned and expanded within the endoluminal prostheses 60, 70, in a manner that is similar to the expandable stents described above, or in any suitable manner. While the prostheses 60, 70 are described as being self-expandable, in modified embodiments, one or both of the prostheses 60, 70 can be partially or wholly balloon expandable, or expandable by any other means.
- Figure 20 is a perspective view of another embodiment of a fenestrated graft or endoluminal prosthesis 1 10 with a scalloped end portion.
- the endoluminal prosthesis 1 10 can have a main body 112, a first, smaller opening 114, a second, larger opening 116, and one or more cutouts 118 (two being shown) formed at any desired location in an end portion of the main body 112 or at any location in the main body 1 12.
- endoluminal prosthesis 110 can be the same as or similar to any of the other endoluminal prostheses disclosed herein, including but not limited to the endoluminal prostheses 10, 60 disclosed herein.
- the endoluminal prosthesis 110 can be deployed and secured in the desired vascular location by any of the same methods as described above with respect to any other endoluminal prostheses, including but not limited to the endoluminal prostheses 10, 60.
- the one or more cutouts 118 can be sized and position so that the main body 1 12 of the endoluminal prosthesis 1 10 does not significantly obstruct the flow into any other branch arteries.
- the cutouts 118 can be advantageous when positioning the endoluminal prosthesis 110 in the vasculature below the SMA.
- Any of the endoluminal prostheses or other grafts disclosed in this application or incorporated by reference herein can be formed so as to comprise the one or more cutouts 118 illustrated in Figure 20.
- sutures or markers made from an RO material can be sewn into or attached to the endoluminal prosthesis 1 10 or any other prosthesis disclosed herein adjacent to one or more of the cutouts 118, one or more of the openings 114, 116 formed therein, near either of the end portions of the main body 1 12, or at any other suitable location.
- Figure 21 is a perspective view of another embodiment of an endoluminal prosthesis 120.
- certain aspects of the endoluminal prosthesis 120 can be the same as or similar to any of the other endoluminal prostheses disclosed herein, including but not limited to the endoluminal prostheses 10, 60, 1 10 disclosed herein.
- the endoluminal prosthesis 120 can have a main body 122 and a branch graft 124.
- the endoluminal prosthesis 120 can have a larger opening 126 formed in the main body 122 at any desired axial or radial position.
- the larger opening 126 can be positioned on the main body 122 at a radial position that opposes the branch graft 124 such that the axial centerline of the larger opening 126 is approximately parallel to the axial centerline of the branch graft 124.
- the branch graft 124 can be integrally formed with or can be sutured, adhered, or otherwise attached to the main body 122 in place of the first, smaller opening 64 described above with reference to endoluminal prosthesis 60.
- the endoluminal prosthesis 120 can be deployed in the same manner as or similar to the method described above for deploying the endoluminal prosthesis 60.
- the endoluminal prosthesis 120 can be deployed by any suitable method. Similar to the embodiment of the endoluminal prosthesis 1 10 illustrated in Figure 20, the endoluminal prosthesis 21 can also have one or more cutouts 118 (not shown) formed at any desired location in an end portion of the main body 122. Further, as with any other endoluminal prosthesis disclosed herein, in some embodiments, sutures or markers made from an RO material can be sewn into or attached to the endoluminal prosthesis 120 adjacent to one or more of the cutouts 118 (not illustrated), adjacent to the opening 126 formed in the main body 122, adjacent to or on the branch graft 124, near either of the end portions of the main body 112, and/or at any other suitable location.
- Figure 22 is a partial section view of a patient's vasculature after a first and second endoluminal prosthesis 120, 130 have been positioned within the patient's vasculature, after the components of the delivery system except for the hollow guidewires 80, 82 have been retracted from the patient's vasculature.
- the second endoluminal prosthesis 130 can be the same as the first endoluminal prosthesis 120 described above.
- the branch graft 124 of the first endoluminal prosthesis 120 can be positioned in the right renal artery 98, while the branch graft 134 of the second endoluminal prosthesis 130 can be positioned within the left renal artery 96.
- each endoluminal prosthesis 120, 130 is independently positionable so as to accommodate a wide range of vasculature geometries or renal arteries without requiring a medical practitioner to custom make the endoluminal prosthesis.
- the branch graft 124, 134 in the endoluminal prostheses 120, 130 can be sized to match the renal artery or branch vessel that the branch graft 124, 134 is intended to be inserted into.
- the position and size of the second larger opening can be configured such that it accommodates a wide range of branch vessel configurations.
- FIGS 23 and 24 are partial section views of a patient's vasculature illustrating the endoluminal prostheses 120, 130 deployed in the desired position within the patient's vasculature, further illustrating a branch graft deployment catheter 140 being guided into the right renal artery 98 over the guidewire 90.
- the branch graft deployment catheter 140 can be guided up the guide wire 90 into the right renal artery 98.
- the balloon can be inflated to secure the branch graft deployment catheter within the renal artery, as discussed above.
- coils or hooks supported by the distal end of the branch graft deployment catheter can be used to secure the branch graft deployment catheter within the renal artery.
- the outer sheath 144 of the deployment catheter 140 can be retracted to deploy the stent 146 supported within the deployment catheter 140, as illustrated in Figure 25.
- the stent 146 illustrated in Figure 24 is a self expanding stent. However, the procedures disclosed herein can easily be modified to accommodate a balloon expandable or other stent suitable for such use.
- Figure 25 is a partial section view of a patient's vasculature illustrating an embodiment of a stent 146 being deployed in the branch graft 124 positioned in a patient's right renal artery 98 by proximally retracting the outer sheath 144 of the deployment catheter 140.
- Figure 26 illustrates the patient's vasculature after the stent 142 has been completely deployed in the branch graft 124 positioned in a patient's right renal artery 98.
- the expansion of the stent 146 can cause the branch graft 124 to expand against the blood vessel 98, so as to secure the graft 124 in the desired position.
- the proximal portion of the branch graft 124 i.e. a portion of the branch graft 124 closest to the main body 122 of the endoluminal prosthesis 120, as illustrated in Figure 25
- Figure 27 is a partial section view of a patient's vasculature illustrating an embodiment of a stent 142 after it has been completely deployed in the branch graft 124 positioned in a patient ' s right renal artery 98, further illustrating the delivery catheter 140 being removed from the patient's vasculature.
- a stent similar to the stent 146 described above can be deployed in the branch graft 134 of the second endoluminal prosthesis 130, so that the branch graft 134 in the left renal artery 96 can be supported in the desired position.
- the branch grafts 124, 134 can be expanded within the renal artery in a manner similar to any of the methods disclosed herein for expanding the branch graft 14 in the blood vessel or renal artery.
- the branch grafts 124, 134 can be expanded within the blood vessel or renal artery following any other suitable method, which can include deploying a self-expanding or balloon expandable bare metal stent or graft covered stent therein after the branch grafts 124, 134 have been positioned in the desired blood vessel or renal artery.
- any of the endoluminal prostheses described herein can be used independently or can be used in conjunction one or more additional grafts, including the grafts disclosed herein or any other suitable grafts such as other tubular or bifurcated grafts.
- any of the endoluminal prostheses disclosed herein or incorporated herein by reference, or either or both of the endoluminal prostheses 120, 130 can be used in conjunction with an additional prosthesis configured the same as or similar to the endoluminal prosthesis 120 to accommodate additional branch vessels, and/or any other suitable prostheses, such as without limitation a bifurcated prosthesis.
- any of the endoluminal prostheses disclosed herein or incorporated herein by reference, or either or both of the endoluminal prostheses 120, 130 can be used with any bifurcated graft positioned in a patient's vasculature to protect a patient's AAA.
- one or more of the endoluminal prostheses disclosed herein can be deployed within the patient's vasculature after the bifurcated graft has been deployed across the patient's AAA.
- the endoluminal prostheses disclosed herein will be positioned within the bifurcated graft it has been deployed across the patient's AAA so as to minimize or prevent blood from flowing between the main tubular portion of the bifurcated graft and the patient's blood vessel.
- the overlap of two or more portions of the endoluminal prostheses each having at least one small and one large opening can combine to create an endoluminal prosthesis system with two or more small openings, which can be used address a wide range of vasculature geometries without requiring any custom fabrication of the prostheses.
- the delivery and graft systems can be used for repairing vasculature in other portions of the body, including but not limited to the SMA, the inferior mesenteric artery, or any other arteries or blood vessels in the body suitable for such procedures or apparatuses.
Abstract
An endoluminal prosthesis system deployable in a region of a patient's vasculature having one or more branch vessels, having a first main graft body having at least a first and second opening therein and a second main graft body having at least a first and a second opening therein. The first openings can be smaller than the second openings. The second main graft body can be expandable substantially within the first main graft body such that the second openings of each graft body do not substantially cover the first openings of the other graft body. The resulting graft system can have two openings therein, each being defined by the first openings in each of the first and second main graft bodies. One or more branch grafts can be attached to cover the openings in the main graft bodies, and the main graft bodies can have one or more cutouts therein.
Description
DESIGN AND METHOD OF PLACEMENT OF A GRAFT OR GRAFT SYSTEM
PRIORITY CLAIM AND INCORPORATION BY REFERENCE
[0001] This application claims the benefit under 35 U.S.C. § 119 of U.S. Provisional Patent Application No. 61/030,913, filed February 22, 2008 (entitled "METHOD OF PLACEMENT OF AN AORTIC GRAFT"), the entirety of which is hereby incorporated by reference as if fully set forth herein.
BACKGROUND Technical Field
[0002] The present invention relates to endoluminal vascular prostheses and methods of placing such prostheses, and, in one application, to endoluminal vascular prostheses for use in the treatment of vessels with branches. Description of the Related Art
|0003] An abdominal aortic aneurysm is a sac caused by an abnormal dilation of the wall of the aorta, a major artery of the body, as it passes through the abdomen. The abdomen is that portion of the body which lies between the thorax and the pelvis. It contains a cavity, known as the abdominal cavity, separated by the diaphragm from the thoracic cavity and lined with a serous membrane, the peritoneum. The aorta is the main trunk, or artery, from which the systemic arterial system proceeds. It arises from the left ventricle of the heart, passes upward, bends over and passes down through the thorax and through the abdomen to about the level of the fourth lumbar vertebra, where it divides into the two common iliac arteries.
[0004] The aneurysm usually arises in the infrarenal portion of the diseased aorta, for example, below the kidneys. When left untreated, the aneurysm may eventually cause rupture of the sac with ensuing fatal hemorrhaging in a very short time. High mortality associated with the rupture led initially to transabdominal surgical repair of abdominal aortic aneurysms. Surgery involving the abdominal wall, however, is a major undertaking with associated high risks. There is considerable mortality and morbidity associated with this magnitude of surgical intervention, which in essence involves replacing the diseased and aneurysmal segment of blood vessel with a prosthetic device which typically is a synthetic
tube, or graft, usually fabricated of polyester, urethane, Dacron.RTM., Tefion.RTM., or other suitable material.
[0005] To perform the surgical procedure requires exposure of the aorta through an abdominal incision which can extend from the rib cage to the pubis. The aorta must typically be closed both above and below the aneurysm, so that the aneurysm can then be opened and the thrombus, or blood clot, and arteriosclerotic debris removed. Small arterial branches from the back wall of the aorta are tied off. The Dacron.RTM. tube, or graft, of approximately the same size of the normal aorta is sutured in place, thereby replacing the aneurysm. Blood flow is then reestablished through the graft. It is necessary to move the intestines in order to get to the back wall of the abdomen prior to clamping off the aorta.
[0006] If the surgery is performed prior to rupturing of the abdominal aortic aneurysm, the survival rate of treated patients is markedly higher than if the surgery is performed after the aneurysm ruptures, although the mortality rate is still quite high. If the surgery is performed prior to the aneurysm rupturing, the mortality rate is typically slightly less than 10%. Conventional surgery performed after the rupture of the aneurysm is significantly higher, one study reporting a mortality rate of 66.5%. Although abdominal aortic aneurysms can be detected from routine examinations, the patient does not experience any pain from the condition. Thus, if the patient is not receiving routine examinations, it is possible that the aneurysm will progress to the rupture stage, wherein the mortality rates are significantly higher.
[0007] Disadvantages associated with the conventional, prior art surgery, in addition to the high mortality rate include the extended recovery period associated with such surgery: difficulties in suturing the graft, or tube, to the aorta; the loss of the existing aorta wall and thrombosis to support and reinforce the graft; the unsuitability of the surgery for many patients having abdominal aortic aneurysms; and the problems associated with performing the surgery on an emergency basis after the aneurysm has ruptured. A patient can expect to spend from one to two weeks in the hospital after the surgery, a major portion of which is spent in the intensive care unit, and a convalescence period at home from two to three months, particularly if the patient has other illnesses such as heart, lung, liver, and/or kidney disease, in which case the hospital stay is also lengthened. Since the graft must
typically be secured, or sutured, to the remaining portion of the aorta, it is many times difficult to perform the suturing step because the thrombosis present on the remaining portion of the aorta, and that remaining portion of the aorta wall may many times be friable, or easily crumbled.
[0008] Since many patients having abdominal aortic aneurysms have other chronic illnesses, such as heart, lung, liver, and/or kidney disease, coupled with the fact that many of these patients are older, the average age being approximately 67 years old, these patients are not ideal candidates for such major surgery.
[0009] More recently, a significantly less invasive clinical approach to aneurysm repair, known as endovascular grafting, has been developed. Parodi, et al. provide one of the first clinical descriptions of this therapy. Parodi, J. C, et al., "Transfemoral Intraluminal Graft Implantation for Abdominal Aortic Aneurysms," 5 Annals of Vascular Surgery 491 (1991). Endovascular grafting involves the transluminal placement of a prosthetic arterial graft in the endoluminal position (within the lumen of the artery). By this method, the graft is attached to the internal surface of an arterial wall by means of attachment devices (expandable stents), typically one above the aneurysm and a second stent below the aneurysm.
[0010] Stents can permit fixation of a graft to the internal surface of an arterial wall without sewing or an open surgical procedure. Expansion of radially expandable stents is conventionally accomplished by dilating a balloon at the distal end of a balloon catheter. In U.S. Pat. No. 4,776,337, for example, Palmaz describes a balloon-expandable stent for endovascular treatments. Also known are self-expanding stents, such as described in U.S. Pat. No. 4,655,771 to Wallsten.
[0011] In certain conditions, the diseased region of the blood vessels extends across branch vessels. The blood flow into these branch vessels is critical for the perfusion of the peripheral regions of the body and vital organs. Many arteries branch off the aorta. For example, the carotid arteries supply blood into the brain, the renal arteries supply blood into the kidneys, the superior mesenteric artery ("SMA") supplies the pancreas, and hypogastric arteries to the reproductive organs, and the subclavian arteries supply blood to the arms. When the aorta is diseased, the branch vessels may also be affected. Thoracic
aortic aneurysms may involve the subclavian and carotid arteries, abdominal aneurysms may involve the SMA, renal and hypogastric arteries. Aortic dissections may involve all branch vessels mentioned above.
[0012] There is a need to place endoluminal prostheses in the aorta without obstructing critical branch vessels. The embodiments of the endoluminal prostheses disclosed herein provide a solution to the problems described above.
SUMMARY OF SOME EXEMPLIFYING EMBODIMENTS
[0013] Some embodiments of the endoluminal prosthesis disclosed herein pertain to the design and method of placement of a branch graft system for endovascular treatment of diseased blood vessels. The branch graft system can comprise a tubular expandable main body and at least one branch graft. The branch graft is made from an expandable material, which can be ePTFE. In some embodiments, the diameter of the branch graft can be sufficiently small to be manipulated into the desired vascular position by moving the branch graft over a guidewire. The branch graft can be expanded to the diameter of the branch vessel by mechanical means, which can be a dilation balloon. In another embodiment of an endoluminal prosthesis, the main body of the branch graft system can have one large opening in the wall of the graft for the treatment of a second branch vessel. A second branch graft system can be placed inside of the first branch graft system, wherein the branch graft of the second branch graft system passed through the opening of the first branch graft system and the large opening of the second branch graft system overlaps with the branch graft of the first branch graft system.
[0014] In some embodiments, an endoluminal prosthesis system is disclosed that can comprise a first endoluminal prosthesis comprising a first main graft body having at least a first and a second opening therein and a second endoluminal prosthesis comprising a second main graft body having at least a first and a second opening therein. The first opening in the first main graft body can be smaller than the second opening in the first main graft body, and the first opening in the second main graft body can be smaller than the second opening in the second main graft body. Further, the second main graft body can be configured to be expandable substantially within the first main graft body such that the second opening of the second main graft body does not cover any portion of the first opening
in the first main graft body, and such that the second opening of the first main graft body does not cover any portion of the first opening in the second main graft body. In some embodiments, when the second main graft body has been expanded within the first main graft body, the resulting endoluminal prosthesis system can have two small openings therein that are each approximately equivalent in diameter to the first opening in each of the first and second main graft bodies.
[0015] In some embodiments, a method of deploying a branch graft system in a portion of a patient's blood vessel having at least a first and a second branch blood vessel is described. In some embodiments, the method can comprise positioning a first main graft body having at least a first and a second opening therein in the patient's blood vessel so that the first opening can be substantially aligned with the first branch blood vessel and so that the second opening can be sufficiently aligned with the second branch blood vessel so that the first main graft body does not substantially cover either the first or second branch blood vessel. The method can further comprise positioning at least a portion of a second main graft body having at least a first and a second opening therein within the inside of the first main graft body so that the first opening of the second main graft body can be substantially aligned with the second branch blood vessel and so that the second opening of the second main graft body can be sufficiently aligned with the first branch blood vessel so that the second main graft body does not substantially cover either the first or second branch blood vessel. The method can further comprise expanding the first and second main graft bodies against the patient's blood vessel to create a multi-layer graft system having two openings through the wall thereof that are substantially aligned with the first and second blood vessels and have a diameter substantially equal to the first opening of each of the first and second main graft bodies, and supporting the first and second main graft bodies against the patient" s blood vessel. In some embodiments the second opening in each of the first and second main graft bodies can be substantially larger than the first opening in each of the first and second main graft bodies.
[0016] In some embodiments, an endoluminal prosthesis is disclosed that can comprise an expandable main graft portion having an axial opening therethrough and at least a first branch opening therein and an expandable branch graft portion having a proximal end
portion, a distal end portion, and an axial opening therethrough. In some embodiments, the branch graft portion can be supported by the main graft portion and the branch graft portion can be supported by the main graft portion so that the proximal end portion of the branch graft portion can be positioned around a periphery of the first branch opening in the main graft, and such that the axial opening through the branch graft portion can be in communication with the first branch opening formed in the main graft portion. In some embodiments, at least the distal end portion of the branch graft portion can be in a first, unexpanded state. In other words, in some embodiments, before the branch graft has been deployed in the desired vascular location, the distal end portion of the branch graft portion can have a diameter that is less than the diameter of the proximal end portion of the branch graft portion.
BRIEF DESCRIPTION OF THE DRAWINGS
[0017J Figure IA is a perspective view of an embodiment of an endoluminal prosthesis.
[0018] Figure IB is a perspective view of the main body graft of the embodiment of the endoluminal prosthesis illustrated in Figure IA.
[0019] Figure 1C is a perspective view of the partially expanded branch graft of the embodiment of the endoluminal prosthesis illustrated in Figure IA.
[0020] Figure ID is a perspective view of the branch graft illustrated in Figure IB before the branch graft 14 has been partially expanded.
[0021] Figure IE is a partial section view of the branch graft illustrated in Figure ID, wherein a portion of the branch graft has been partially expanded with the use of the balloon expander.
[0022] Figure 2 is a partial section view of a portion of the embodiment of the endoluminal prosthesis illustrated in Figure IA, after the branch graft portion of the endoluminal prosthesis has been positioned within a branch artery.
[0023] Figure 3 is a partial section view of a portion of the embodiment of the endoluminal prosthesis illustrated in Figure IA, showing a balloon expandable stent being positioned within the partially expanded branch graft of the endoluminal prosthesis.
[0024] Figure 4 is a partial section view of a portion of the embodiment of the endoluminal prosthesis illustrated in Figure IA, showing a balloon expandable stent being expanded within the branch graft of the endoluminal prosthesis.
[0025] Figure 5 is a partial section view of a portion of the embodiment of the endoluminal prosthesis illustrated in Figure IA, showing an expanded stent positioned within a branch graft of the endoluminal prosthesis.
[0026] Figure 6 is a graphical illustration of the location of the two renal arteries with respect to the superior mesenteric artery ("SMA") in 50 patients undergoing an abdominal aortic aneurysm C'AAA") procedure.
[0027] Figures 7A and 7B are a front view and a section view, respectively, of another embodiment of an endoluminal prosthesis.
[0028] Figures 8A, 8B, and 8C are a perspective view, top view, and section view, respectively, of yet another embodiment of an endoluminal prosthesis.
[0029] Figures 9A and 9B are a perspective view and a side view, respectively, of an embodiment of a fenestrated endoluminal prosthesis.
[0030] Figures 1 OA and 1 OB are a perspective view and a side view, respectively, of another embodiment of a fenestrated endoluminal prosthesis.
[0031] Figures 1 IA and 1 IB are a perspective view and a side view, respectively, of another embodiment of a fenestrated endoluminal prosthesis.
[0032] Figure 12 is a partial section view of the endoluminal prosthesis illustrated in Figures 1OA, 1OB positioned within an embodiment of a delivery catheter.
[0033] Figure 13 is a side view of the embodiment of the endoluminal prosthesis illustrated in Figures 1OA. 1 OB before the endoluminal prosthesis is placed in a delivery catheter.
[0034] Figure 13 is a partial section view of the embodiment of the endoluminal prosthesis illustrated in Figure 1OA after the outer sheath of the delivery catheter illustrated in Figure 12 has been retracted.
[0035] Figure 14 is a partial section view of a patient's vasculature illustrating guidewires inserted through the abdominal aortic and into the renal arteries.
[0036] Figure 15 is a perspective view of the embodiment of the endoluminal prosthesis illustrated in Figures 1 OA, 1 OB in the deployed or expanded state.
[0037] Figure 16 is a partial section view of a patient's vasculature illustrating the endoluminal prosthesis illustrated in Figures 1OA, 1OB deployed in the desired position within the patient's vasculature, after the components of the delivery system except for the guidewires have been retracted from the patient's vasculature.
[0038] Figure 17 is a partial section view of a patient's vasculature illustrating the endoluminal prosthesis illustrated in Figures 1OA, 1OB deployed in the desired position within the patient's vasculature, after all of the components of the delivery system have been retracted from the patient's vasculature.
[0039] Figure 18 is a partial section view of a patient's vasculature illustrating the endoluminal prosthesis illustrated in Figures 1 IA, 1 IB also deployed in the desired position within the patient's vasculature, after the components of the delivery system except for the guidewires have been retracted from the patient's vasculature.
[0040] Figure 19 is a partial section view of a patient's vasculature illustrating both endoluminal prostheses positioned in the desired position within the patient's vasculature, after the components of the delivery system have been retracted from the patient's vasculature.
[0041] Figure 20 is a perspective view of another embodiment of an endoluminal prosthesis with a scalloped end portion.
[0042] Figure 21 is a perspective view of another embodiment of an endoluminal prosthesis with a large opening open to the proximal end of the graft.
|0043] Figure 22 is a partial section view of a patient's vasculature illustrating two of the endoluminal prostheses illustrated in Figure 21 deployed in the desired position within the patient's vasculature, after the components of the delivery system except for the hollow guidewires have been retracted from the patient's vasculature.
[0044] Figures 23 and 24 are partial section views of a patient's vasculature illustrating two of the endoluminal prostheses illustrated in Figure 21 deployed in the desired position within the patient's vasculature, further illustrating a branch graft deployment catheter being guided into the right renal artery over a guidewire.
[0045] Figure 25 is a partial section view of a patient's vasculature illustrating an embodiment of a stent being deployed in the branch graft positioned in a patient's right renal artery.
[0046] Figure 26 is a partial section view of a patient's vasculature illustrating an embodiment of a stent after it has been deployed in the branch graft positioned in a patient's right renal artery.
[0047] Figure 27 is a partial section view of a patient's vasculature illustrating an embodiment of a stent after it has been deployed in the branch graft positioned in a patient's right renal artery, further illustrating the delivery catheter being removed from the patient's vasculature.
DETAILED DESCRIPTION OF SOME EXEMPLIFYING EMBODIMENTS [0048] The following detailed description is now directed to certain specific embodiments of the disclosure. In this description, reference is made to the drawings wherein like parts are designated with like numerals throughout the description and the drawings.
[0049] Certain embodiments described herein are directed to systems, methods, and apparatuses to treat lesions, aneurysms, or other defects in the aorta, including, but not limited to, the thoracic, ascending, and abdominal aorta, to name a few. However, the systems, methods, and apparatuses may have application to other vessels or areas of the body, or to other fields, and such additional applications are intended to form a part of this disclosure. For example, it will be appreciated that the systems, methods, and apparatuses may have application to the treatment of blood vessels in animals. In short, the embodiments and/or aspects of the endoluminal prosthesis systems, methods, and apparatuses described herein can be applied to other parts of the body or may have other applications apart from the treatment of the thoracic, ascending, and abdominal aorta. And, while specific embodiments may be described herein with regard to particular portions of the aorta, it is to be understood that the embodiments described can be adapted for use in other portions of the aorta or other portions of the body and are not limited to the aortic portions described.
[0050] Figure IA is a perspective view of an embodiment of an endoluminal prosthesis 10 (also sometimes referred to herein as a branch graft system) having a main body graft 12 and at least one branch graft 14. The branch graft 14 is shown in a partially expanded state. In some configurations, the main body graft 12 can be positioned in the abdominal aorta, which the branch graft or grafts 14 can be positioned within the left or right renal artery. In some configurations, the branch graft or grafts 14 can be positioned within any one or combination of the following: left renal artery, right renal artery, second lumbar, testicular, inferior mesenteric, middle sacral, or other vessels branching from the aorta. Thus, in some embodiments, the endoluminal prosthesis 10 can comprise any number of branch grafts 14 that are required for the specific application, including, but not limited to, two, three, or more branch grafts 14.
[0051] Because the branch graft or grafts 14 can be configured to confonn to a wide range of vessels and a wide range of positions, the branch graft or grafts 14 can be of any suitable size, shape, or configuration, and can be attached to the main body graft 12 in any of a wide variety of locations. Therefore, some embodiments of the endoluminal prosthesis 10 can comprise only one branch graft 14. However, in some embodiments, the endoluminal prosthesis 10 can comprise two or more branch grafts 14, or any suitable number depending on the application.
[0052] Figure IB is a perspective view of the main body graft 12 of the embodiment of the endoluminal prosthesis 10 illustrated in Figure IA. Figure 1C is a perspective view of the partially expanded branch graft 14 of the embodiment of the endoluminal prosthesis 10 illustrated in Figure IA. Figure 1C illustrates the branch graft 14 before it has been assembled with the main body graft 12 to form the embodiment of the endoluminal prosthesis 10 illustrated in Figure IA. Figure ID is a perspective view of the branch graft 14 illustrated in Figure IB before the branch graft 14 has been partially expanded. Figure 1 E is a partial section view of the branch graft illustrated in Figure 1 D, wherein a portion of the branch graft 14 has been partially expanded with the use of the balloon expander 16.
[0053] With reference to Figures IA- IE, one of many suitable methods for fabricating some embodiments of the endoluminal prosthesis 10 will be described. As will
be described, the branch graft 14 in the pre-expanded state as shown in Figure ID can be partially expanded by the balloon expander 16 to form the partially expanded branch graft 14 shown in Figures IA, 1C. In some embodiments, only the proximal end portion 14a of the branch graft 14 (i.e., the end of the branch graft 14 closest to opening 14b) can preferably be expanded by the balloon expander 16. To expand the branch graft 14, the balloon expander 16 can be partially inserted into the proximal end portion 14a of the pre-expanded branch graft 14 (shown in Figure ID) and inflated until the proximal end portion 14a of the branch graft 14 reaches the desired or suitable size. While the expansion being of the branch graft 14 can be performed with a balloon expander 16, as is illustrated in Figure IE, any suitable method of expanding the branch graft 14 can be employed, including but without limitation other forms of mechanical expanders. Thus, Figure IE illustrates only one of several suitable methods for partially expanding the pre-expanded branch graft 14 illustrated in Figure ID to form the partially expanded branch graft 14 illustrated in Figure IA, 1C.
[0054] In some arrangements, the proximal end portion 14a of the branch graft 14 can be expanded to approximately match or conform to the expected diameter of the branch vessel and/or the diameter of the opening 12a. Thus, the branch graft 14 can be configured so as to be expandable over a wide range of sizes and cross-sectional shapes, depending on the size or shape of the branch vessel that the branch graft 14 is intended to be supported by. After removing the balloon expander 16, the proximal portion of the partially expanded branch graft 14 can be trimmed to conform to the opening 12a formed in the main body graft 12. The opening 12a can be sized and positioned to conform to the desired size location of the partially expanded branch graft 14. Thereafter, as mentioned, the branch graft 14 can be attached to the main body graft 12 using adhesive, sutures, or any other suitable attachment method, to form the endoluminal prosthesis 10 illustrated in Figure IA. Any portion of the endoluminal prosthesis 10, including the main body graft 12 and/or the branch graft 14, or any other endoluminal prosthesis disclosed herein can be formed from PTFE, ePTFE, polyester, urethane, Dacron, Dacron.RTM., Teflon.RTM., or any other distensible polymeric material or other suitable material.
[0055] In some embodiments, the sutures used to attach the branch graft 14 (or any other branch graft disclosed herein) to the main body 12 (or any other main body or graft
portion disclosed herein) can be made from a radiopaque ("RO") material so that the location of the branch graft can be perceived in an x-ray or other radiation transmission during deployment, hi some embodiments, the sutures can be made from platinum, gold, barium sulfate, or any other suitable RO material. Alternatively, RO markers can be sewn to or otherwise attached to the main body of the endoluminal prosthesis at any suitable position, such as but not limited to adjacent to or on the branch graft or near the end portions of the main body, again to aid in visualization of the endoluminal prosthesis during deployment.
[0056] hi some embodiments, the diameter of the pre-expanded branch graft 14 (shown in Figure ID) can be from approximately 1 mm or less to approximately 3 mm or more. However, the pre-expanded diameter of the pre-expanded branch graft 14 (as illustrated in Figure ID) can be any suitable cross-sectional size or shape depending on the size and shape of the target artery or blood vessel. Additionally, in some embodiments, the shape of the pre-expanded branch graft 14 can be cylindrical. However, the shape of the pre- expanded branch graft 14 is not so limited. The pre-expanded branch graft 14 can define a curved, angled, tapered or other suitable shape.
[0057] hi some embodiments, the branch graft 14 can be integrally formed with the main body graft 12. hi some embodiments, the branch graft 14 can be attached to the main body graft 12 using sutures, adhesive, or any other suitable attachment material or method. The junction between the branch graft or grafts 14 and the main body graft 12 can be sealed so as to substantially inhibit or prevent blood from leaking through the junction and flowing between the main body graft 12 and the aorta or other blood vessel that the main body graft 12 is positioned within. In some embodiments, the junction between the branch graft or grafts 14 and the main body graft 12 can be sealed so as to inhibit or prevent at least the majority of the blood flowing therethrough from leaking through the junction and flowing between the main body graft 12 and the aorta or other blood vessel that the main body graft 12 is positioned within. In this configuration, the endoluminal prosthesis 10 can be less susceptible to leakage between the main body graft 12 and the aorta or blood vessel at the blood vessel branch point as compared to conventional fenestrated graft systems.
[0058] In some embodiments, the main body graft 12 or the branch graft 14 of the endoluminal prosthesis 10 can be similar in size, material, or other details to other suitable
expandable bifurcated or non-bifurcated endoluminal prostheses presently known or later developed in the art, or can be of any size, material, or other details of any other prosthesis presently known or later developed in the art. For example, without limitation, in some embodiments, the main body graft 12 or the branch graft 14 can comprise any of the materials, features, or other aspects of the embodiments of the polymeric sleeves or the tubular wire supports disclosed in U.S. Patent No. 6,077,296 (titled ENDOLUMINAL VASCULAR PROSTHESIS and filed on March 4, 1998), U.S. Patent No. 6,187,036 (titled ENDOLUMINAL VASCULAR PROSTHESIS and filed on DECEMBER 1 1, 1998), U.S. Patent No. 6,197,049 (titled ARTICULATING BIFURCATION GRAFT and filed on FEB. 17, 1999), U.S. Patent No. 6,500,202 (titled BIFURCATION GRAFT DEPLOYMENT CATHETER and filed on March 15, 2000), U.S. Patent No. 6,660,030 (titled BIFURCATION GRAFT DEPLOYMENT CATHETER and filed on DECEMBER 22, 2000), or U.S. Patent No. 6,733,523 (titled IMPLANTABLE VASCULAR GRAFT and filed on JUN. 26, 2001). The entirety of each of the above-listed patents are hereby incorporated by reference as if fully set forth herein.
[0059] For example, in some embodiments, the main body graft 12 and/or the branch graft 14 can be expanded using an uncovered (i.e., bare) self-expanding metal frame or a self-expanding metal frame covered with a thin graft material, which can be made from ePTFE, as disclosed in U.S. Patent No. 6,077,296. However, the specific design and selection of the materials, shapes, or other aspects for the main body graft 12 or the branch graft 14 of the endoluminal prosthesis 10 is not limited to the designs and configurations disclosed or incorporated by reference herein, but can be based on any suitable variety of materials, shapes, or other aspects of any other suitable endoluminal prostheses. Additionally, the main body graft 12 and/or the branch graft 14 (or any other main or branch graft disclosed herein) can be expanded using a mechanical expander, and be held in the expanded position against the blood vessel wall by the blood pressure within the vessel (i.e., without the use of a stent).
[0060] In some embodiments, the main body graft 12 can comprise an expandable metal frame to support the main body graft 12 within the aorta (not illustrated). The frame supporting the main body graft 12 of the endoluminal prosthesis 10 can be foπned from a
metal or any other suitable material, and can be configured so as to not obstruct the flow of blood through the opening 14b in the branch graft or grafts 14. The metal frame can comprise a self-expandable structure comprising one or more wires forming a zig-zag, tubular shape, as described above with reference to U.S. Patent Nos. 6,077,296, 6,187,036, 6,197,049, 6,500,202, 6,660,030 and/or 6,733,523. In some embodiments, the metal frame can be formed by laser cutting a tubular structure. Such structures are well known in the art. However, those of skill in the art will recognize that various configurations and constructions of the frame can be used in light of the disclosure herein.
[0061] Figure 2 is a partial section view of a portion of the embodiment of the endoluminal prosthesis 10 illustrated in Figure IA, after the branch graft portion 14 of the endoluminal prosthesis 10 has been positioned within a branch vessel artery (represented by BV in Figure 2). Figure 3 is a partial section view of a portion of the embodiment of the endoluminal prosthesis 10 illustrated in Figure IA, showing a balloon expandable stent being positioned within the partially expanded branch graft 14 of the endoluminal prosthesis 10. Figure 4 is a partial section view of a portion of the embodiment of the endoluminal prosthesis 10 illustrated in Figure IA, showing a balloon expandable stent being expanded within the branch graft 14 of the endoluminal prosthesis 10. Figure 5 is a partial section view of a portion of the embodiment of the endoluminal prosthesis 10 illustrated in Figure IA, showing an expanded stent positioned within a branch graft 14 of the endoluminal prosthesis 10.
[0062] With reference to Figures 2-5, one method of positioning and implanting the fully assembled endoluminal prosthesis 10 in the desired aortic location will now be described. After advancing a guidewire 18 through the vasculature into the desired branch vessel BV by known or suitable methods, the partially expanded branch graft 14 of the endoluminal prosthesis 10 can be guided over the guidewire 18 so that the main body graft 12 is positioned within the desired location in the aorta and the branch graft 14 is positioned in the desired branch vessel (represented by BV in Figure 2).
[0063] With reference to Figure 3, once the partially expanded branch graft 14 is positioned within the desired branch vessel BV, a balloon-expandable stent 20 can be guided over the guidewire 18 and positioned inside the partially expanded branch graft 14. As
shown in Figure 4, the balloon expandable stent 20 can be expanded by the expansion of a balloon 22 positioned within the balloon expandable stent 20. Once the stent 20 of the branch graft 14 has been expanded by the balloon 22, a balloon 22 can be deflated, leaving the expanded stent 20 positioned within the branch graft 14, as illustrated in Figure 5.
[0064] The main body graft 12 and/or branch graft 14 the can be expanded and secured in the desired position by any other suitable method for such. Suitable expansion apparatuses and methods include, but are not limited to, balloon catheters, dilators, and self- expanding stents or stent grafts. Other means of securing the main body graft 12 and/or branch graft 14 may include, without limitation, self-expanding stents, stent grafts, sutures, and staples.
|0065] In some embodiments, the stent 20 can be a bare wire stent of any configuration described above or incorporated herein by reference. In some embodiments, the stent 20 can be a graft covered stent, also of any configuration described above or incorporated herein by reference. A graft covered stent can provide a greater degree of safety to the patient by providing a double layer graft system that can be less prone to tearing or other damage.
[0066] In some arrangements, after the branch stent 20 and the branch graft 14 have been expanded within the desired branch vessel, the main body graft 12 may thereafter be expanded within the aorta, hi some arrangements, the main body graft 12 can be expanded within the aorta prior to expanding the branch stent 14 within the branch vessel BV. The main body graft 12 can be expanded and held in the desired position using a self- expandable stent, or can be expanded and held in position by any other suitable stent device, such as without limitation, a balloon expandable stent. As such, similar to the branch graft 14, the main body graft 12 can be expanded and held in position with a bare metal stent or a covered stent, or any of the stents described or incorporated by reference herein.
[0067] Some embodiments of the endoluminal prosthesis 10 can be implanted within the desired vessel in a multistep process, such that an integrated deployment mechanism is not used for such embodiments of the endoluminal prosthesis 10. The expansion and stenting of the branch graft 14 can be performed in a secondary procedure, after the branch graft 14 has been positioned in the desired blood vessel.
[0068] As mentioned, in certain situations, several vessels may branch off from the main blood vessel in the location that is desired to be stented. In this case, the endoluminal prosthesis 10 can be formed with multiple branch grafts 14 formed therein or secured thereto. For example, the two renal arteries and the superior mesenteric artery ("SMA") generally branch off from the aorta in close proximity to each other. The positions of the branch vessels generally vary from patient to patient, as shown in Figure 6, which is a graphical illustration of the location of the two renal arteries with respect to the SMA in 50 patients undergoing an abdominal aortic aneurysm (AAA) procedure. For reference, the SMA is located at the origin of the graph. The locations of the left and right renal arteries are expressed in terms of axial distance from the SMA in millimeters (x-axis), and circumferential angle from the SMA (y-axis). As Figure 6 illustrates, there is typically a large variability in the locations of the vessels from one patient to the next.
[0069] Figure 6 indicates that, in case of stent grafting across the renal arteries, the small and the large opening are approximately 180 degrees opposite to each other. In some embodiments, the large opening can be sufficiently large to accommodate an axial distance between the renal arteries of between approximately 15 mm and approximately 20 mm, and a circumferential asymmetry of +/- 20 degrees. Thus, in some embodiments, the large opening may have a diameter of approximately 20 mm.
[0070] Figures 7A and 7B are a front view and a section view, respectively, of another embodiment of an endoluminal prosthesis 30 having a main body graft 32 and a branch graft 34. Figures 8A, 8B, and 8C are a perspective view, top view, and section view, respectively, of another embodiment of an endoluminal prosthesis 40 having a main body graft 42 and a branch graft 44.
[0071] The embodiments of the endoluminal prostheses in Figures 7A-8B can be configured for application in portions of the body other than in the portions of the aorta described above. For example, some embodiments of the endoluminal prosthesis 30 illustrated in Figures 7A, 7B can be configured for application in a specific artery or arteries. In particular, without limitation, the embodiment of the endoluminal prosthesis 30 illustrated in Figures 7A, 7B can be configured for use in the thoracic aorta, with the branch graft 34 configured for positioning within the subclavian artery. As illustrated, in Figures 7A, 7B, the
main body graft 32 can define curved portion that may be suitable for curved vessels such as that of the subclavian artery. Other aspects of the endoluminal prosthesis 30 can be the same as or similar to any of the other endoluminal prostheses disclosed herein, and the endoluminal prosthesis 30 can be deployed and secured in the desired artery by any of the same methods as described above with respect to endoluminal prosthesis 10.
[0072] Similarly, some embodiments of the endoluminal prostheses 40 illustrated in Figures 8A, 8B can also be configured for application in a specific artery or arteries. For example, without limitation, the embodiments of the endoluminal prosthesis 40 illustrated in Figures 8A, 8B can be configured for use in the iliac artery, with the branch graft 44 configured for positioning within the hypogastric artery or arteries. However, there are many locations in the body that would benefit from a placement of a branch graft systems or endoluminal prostheses disclosed herein to ensure perfusion of branch vessels, and none of the embodiments of the endoluminal prostheses disclosed herein are confined to any particular portion of the body. The examples described with regard to Figures 7A-8B merely serve as illustrations of potential applications of such a branch graft system. Other aspects of the endoluminal prosthesis 40 can be the same as or similar to any of the other endoluminal prostheses disclosed herein, and the endoluminal prosthesis 40 can be deployed and secured in the desired artery by any of the same methods as described above with respect to endoluminal prosthesis 10.
[0073] The issue of variability in the anatomy has been overcome in the past by providing custom-made fenestrated grafts in which the openings (commonly referred to as fenestrations) are formed in the main body graft, which were generally custom-made to fit vessels of the individual patient. One disadvantage of custom making the fenestrated grafts after examining the individual patients vascular anatomy is that, as mentioned, the patient's anatomy is generally required to be closely examined using imaging scans prior to fabricating the fenestrated graft. Subsequently, image analysis is typically required to be perfoπned to determine the geometrical relationship between the particular patient's main vessel and the branch vessels. This generally required the medical practitioner to individually build or modify the endoluminal prosthesis to create fenestrations at the appropriate location of the branch vessels. The custom-made graft then is generally required to be placed exactly in the
correct location in the blood vessel to ensure that the fenestrations are properly aligned with the branch vessel. Another disadvantage is that this can be a multi-step, time consuming procedure. It is not uncommon to require several months to prepare a custom-made graft for the patient. Additionally, the deployment of a custom-made endoluminal prosthesis can be very difficult, typically requiring a high skill level in endovascular procedures.
[0074] The following embodiments present additional alternatives to the custom- made fenestrated grafts discussed above. Figures 9A and 9B are a perspective view and a side view, respectively, of an embodiment of a fenestrated endoluminal prosthesis or graft 50. As illustrated in Figures 9A, 9B, the fenestrated graft 50 can have two openings or fenestrations 52a, 52b formed in the main graft 50. Any of a wide ranging variety of fenestrated grafts 50 can be manufactured, each having a different location of the two openings or fenestrations 52a, 52b formed therein so that the doctor can select the appropriately configured fenestrated graft 50 depending on the patient's particular vasculature.
[0075] Figures 1OA and 1OB are a perspective view and a side view, respectively, of an embodiment of a fenestrated endoluminal prosthesis 60 (also referred to herein as a first endoluminal prosthesis or graft), which present an alternative to the custom-made fenestrated grafts discussed above. To facilitate and description of some of the embodiments disclosed herein, the placement of the fenestrated endoluminal prosthesis 60 at the renal arteries is described. However, the embodiments of the fenestrated endoluminal prostheses 60 disclosed herein are not limited to this particular location or application. This application merely serves as an example to illustrate the basic aspects of the fenestrated endoluminal prosthesis 60.
[0076] In some embodiments, the endoluminal prosthesis 60 can comprise a main body 62 and first and second openings 64, 66, respectively. The main body 62 can have an inside surface 62a and an outside surface 62b. In some embodiments, the endoluminal prosthesis 60 can comprise any suitable or desired number of openings. For example, without limitation, the endoluminal prosthesis 60 can have one or more openings or cutouts (not illustrated) in addition to the openings 64, 66 illustrated in Figures 1OA, 1OB to account
for other renal or branch arteries that may otherwise be covered by the main body 62 of the endoluminal prosthesis 60.
[0077] In the embodiment of the endoluminal prosthesis 60 illustrated in Figures 1OA, 1OB, the openings 64, 66 can be positioned at mutually or diametrically opposing locations. However, the openings 64, 66 can be positioned at any desired or suitable axial or radial position. Additionally, in the embodiment of the endoluminal prosthesis 60 illustrated in Figures 1OA, 1OB, the openings 64, 66 can have a circular shape. However, the openings 64, 66 can have any desired or suitable shape, including square, rectangular, polygonal, or otherwise.
[0078] Further, in the illustrated embodiment where each of the openings are generally circular, the diameter of the second opening 66 can be approximately four times greater than the diameter of the first opening 64. In some embodiments, the diameter of the second opening 66 can be between approximately two times greater and approximately four times greater, or between approximately four times greater and approximately six times or more greater than the diameter of the first opening 64. Additionally, in some embodiments, the second opening 66 can be configured to be as large as is possible to cover a wide range of branch vessel anatomies. As the size of the second opening 66 is increased, the potential to treat a large range of branch vessel anatomies is also increased.
[0079] Similarly, in some embodiments where the openings are non-circular, the width and/or height of the second opening 66 can be approximately four times greater than the width and/or height of the first opening 64. In some embodiments, the width and/or height of the second opening 66 can be between approximately two times greater and approximately four times greater, or between approximately four times greater and approximately six times or more greater than the width and/or height of the first opening 64.
[0080] In some embodiments, similar to any other prosthesis disclosed herein, the prosthesis 60 can be self-expanding, balloon expandable, or can be of any other suitable configuration. The openings 64, 66 can be configured to be positioned adjacent to the two renal arteries. The first opening 64 can approximately match the size of the first renal artery, while the second opening 66 can be substantially larger that the first opening 64. As will be described in greater detail below, the size of the second opening 66 can be greater than the
size of the first opening 64 to account for the variability in the location of the second renal artery with respect to the first renal artery. In this configuration, the endoluminal prosthesis 60 can be positioned within the patient's vasculature so that the main body 62 of the endoluminal prosthesis 60 does not cover the second renal when the first opening 64 of the main body 62 is aligned with the patient's first renal artery.
[0081] As will be described in greater detail below, to seal the area around the second renal artery after the first endoluminal prosthesis 60 has been positioned in the patient's vasculature, another fenestrated endoluminal prosthesis 70 (also referred to herein as a second endoluminal prosthesis or graft) comprising a main body 72, a first or smaller opening 74, and a second or larger opening 76, can be inserted into the patient's vasculature on the inside of the first endoluminal prosthesis 60. Figures 1 IA and 1 IB are a perspective view and a side view, respectively, of the embodiment of the fenestrated endoluminal prosthesis 70. The main body 72 can have an inside surface 72a and an outside surface 72b.
[0082] The first or smaller opening 74 of the second endoluminal prosthesis 70 can be positioned within the patient's vasculature so as to be aligned with the patient's second renal artery. The second or larger opening 76 of the second endoluminal prosthesis 70 can ensure that the first renal artery is not covered by the main body 72 of the second endoluminal prosthesis 70. The second, larger opening 66 in the first endoluminal prosthesis 60 and the second, larger opening 76 in the second endoluminal prosthesis 70 can allow for greater variability in the location of the renal arteries, without requiring a medical practitioner to custom make the prosthesis.
[0083] In particular, after the first endoluminal prosthesis 60 has been positioned in the patient's vasculature so that the outside surface 62b can expand against and contact the walls of the patient's artery and so that the first or smaller opening 64 is approximately aligned with the first renal artery and the second or larger opening 66 is sufficiently aligned with the second renal artery so that the main body 62 does not cover the second renal artery, the second endoluminal prosthesis 70 can be positioned within the patient's vasculature so that the first or smaller opening 74 is approximately aligned with the patient's second renal artery and the second or larger opening 76 is sufficiently aligned with the first renal artery so that the main body 72 does not cover the first renal artery. The second endoluminal
prosthesis 70 can then be expanded so that the outside surface 72b of the main body 72 of the second endoluminal prosthesis 70 is in contact with the inside surface 62a of the main body 62 of the first endoluminal prosthesis 60.
[0084] In some embodiments, the second endoluminal prosthesis 70 can be the same as or similar to the first endoluminal prosthesis 60 including, but not limited to, having the same number, size, and location of the openings as are in the first endoluminal prosthesis 60. hi some embodiments, the second endoluminal prosthesis 70 can have a different configuration as compared to the first endoluminal prosthesis 60 including, but not limited to, having a different number, size, and/or location of the openings that are formed in the main body 72 of the second endoluminal prosthesis 70.
[0085] Again, the size and shape of the openings 64, 66, 74, 76 are not limited to the illustrations or the description set forth above, but can be any suitable size or shape, or can be positioned at any suitable location on the endoluminal prosthesis 60, 70, respectively. Additionally, the size, shape, or other aspects of the configuration of the endoluminal prostheses 60, 70 are not limited to the specific embodiments described or illustrated herein. The endoluminal prostheses 60, 70 can comprise any suitable size, shape, including openings or cutouts (i.e., scallops) formed in the proximal and/or distal ends thereof or other aspects of other suitable configurations known or later developed in the field including, but not limited to, other known expandable non-bifurcated and bifurcated prostheses. For example, without limitation, in some embodiments, the main body 62, 72 of the prostheses 60, 70, respectively, can comprise any of the materials, features, or other aspects of the embodiments of the endoluminal vascular prostheses disclosed in U.S. Patent Nos. 6,077,296, 6,187,036. 6,197,049, 6,500,202, 6,660,030 and/or 6,733,523, the entirety of which are hereby incorporated by reference as if fully set forth herein.
[0086] Without limitation, in some embodiments, the main body 62, 72 of the endoluminal prostheses 60, 70 may comprise any of the materials, shapes, or other aspects of the polymeric sleeves and/or the tubular wire supports disclosed in U.S. Patent Nos. 6,077,296, 6,187,036, 6,197,049, 6,500,202, 6,660,030 and/or 6,733,523. However, the specific design and selection of the materials, shapes, or other aspects for each of the main bodies 62, 72 of the endoluminal prostheses 60, 70 are not limited to those set forth in patents
set forth above, but can be based on any suitable variety of materials, shapes, or other aspects of any other suitable endoluminal prostheses. In addition, the techniques and constructions of U.S. Patent Nos. 6,187,036, 6,197,049, 6,500,202, 6,660,030 and/or 6,733,523, the entire contents of which are hereby incorporated by reference herein, can also be used and/or adapted for use with the main body 62, 72.
[0087] With reference to Figures 12-19, the deployment of the fenestrated endoluminal prosthesis system described above will be described in greater detail. Figure 12 is a partial section view of the endoluminal prosthesis 60 illustrated in Figures 1OA, 1OB positioned within an embodiment of a delivery catheter 78. Figure 13 is a side view of the embodiment of the endoluminal prosthesis 60 illustrated in Figures 1OA, 1OB before the endoluminal prosthesis 60 is placed in a delivery catheter 78. With reference to Figures 12, 13, the hollow guidewires 80, 82 can be placed through the openings 64, 66, respectively, of the endoluminal prosthesis 60. In some embodiments, the guidewires 80, 82 can be made from a plastic extrusion or metal braids. For example, in some embodiments, the hollow guidewires 80, 82 can be made from braided Nitinol wire. In some embodiments, the outer diameter of the guidewires 80, 82 can be approximately 0.035in and the lumen of the guidewire can be approximately 0.016in to accommodate a second 0.014 in guidewire. In some embodiments, the guidewires 80, 82 can be configured to pass over a 0.018in or any other suitable guidewire. Figure 14 is a partial section view of a patient's vasculature illustrating guidewires 90, 92 inserted through the abdominal aortic 94 and into the renal arteries 96, 98, respectively.
|0088] In some embodiments the guidewires 80, 82 can support balloons on the distal end of the guidewires 80, 82. The balloons can be inflated in the branch vessel to removably anchor or support the guidewire 80, 82 against the vessel wall and prevent inadvertent removal of the guidewires from the branch vessels during the deployment procedure. In some embodiments, for example, one or more occlusion balloon catheters can be used. Other anchoring mechanisms can be attached to the guidewire, such as, without limitation, hooks, to removably secure one or more of the guidewires 80, 82 within or to the vessel.
[0089] Additionally, in some embodiments, one of more of the guidewires disclosed herein (such as, without limitation, guidewires 80, 82) can have a coiled distal end portion. The coiled distal end portion can be configured to be insertable into a branch vessel and can be biased to remain in the branch vessel. In particular, in some embodiments, the size or diameter of the coils can be greater than the inside diameter of the branch vessel so as to bias the coiled portion to remain within the branch vessel when the proximal end of the guidewire is retracted. In this configuration, proximal retraction of the guidewire can cause a proximal end of the coil to unravel, allowing a portion of the coiled portion of the guidewire to be unraveled and retracted while the remaining portion of the coiled portion can remain within the branch vessel. This configuration can inhibit the distal end portion of the guidewire from being inadvertently removed from the branch vessel. To completely remove the coiled distal end portion from the branch vessel, the guidewire can be retracted until the entire coiled portion is unraveled and retracted.
[0090] In some embodiments, the length of the coiled portion can be approximately 6 cm. In some embodiments, the length of the coiled portion can be between approximately 3 cm or less and approximately 5 cm, or between approximately 5 cm and approximately 7 cm, or between approximately 7 cm and approximately 9 cm or more, or from or to any values in these ranges. In some embodiments, the unraveled length of the coiled portion can be approximately 20 cm. In some embodiments, the unraveled length of the coiled portion can be between approximately 10 cm or less and approximately 15 cm, or between approximately 15 cm and approximately 20 cm, or between approximately 20 cm and approximately 25 cm or more, or from or to any values in these ranges.
[0091] However, the guidewires 80, 82 or any other guidewires disclosed herein can have any desired or suitable configuration. For example, the guidewires 80, 82 or any other guidewires disclosed herein can have the same or similar materials, configurations, methods of fabrication, and other aspects or details as the hollow guidewires set forth in U.S. Patent Application Publication No. US 2004-0098087 Al, titled DUAL WIRE PLACEMENT CATHETER (Application No. 10/706,660), filed on November 12, 2003, and U.S. Application No. 11/623,022, titled DUAL CONCENTRIC GUIDEWIRE AND
METHODS OF BIFURCATED GRAFT DEPLOYMENT, filed on January 12, 2007, the entirety of both of which are incorporated by reference herein as if fully set forth herein.
[0092] With reference to Figure 12, the collapsed endoluminal prosthesis 60 can be supported within the outer sheath 84 of the delivery catheter 78 in the space between the catheter shaft 86 and the catheter tip 88. In some embodiments, the hollow guidewires 80, 82 can slide through openings or lumens in the catheter shaft 86. Alternatively, in some embodiments, the hollow guidewires 80, 82 can be fixed to the catheter shaft 86.
[0093] The hollow guidewires 80, 82 can pass through the outer sheath 84 from the proximal end of the delivery catheter 78 to the distal end of the delivery catheter 78. Each of the hollow guidewires 80, 82 can be configured to receive or allow the insertion of 0.014 in guidewire therethrough. In this configuration, the hollow guidewires 80, 82 can pass over guidewires 90, 92 that can be pre-placed in the appropriate vasculature.
[0094] In this configuration, the endoluminal prosthesis 60 can be retained in the delivery catheter 78 by the outer sheath 84. As will be described in greater detail, retraction of the outer sheath 84 can deploy the endoluminal prosthesis 60. With the outer sheath 84 retracted, the endoluminal prosthesis 60 can expand either by self-expansion, balloon expansion, or by any other suitable method or mechanism. Figure 15 is a perspective view of the embodiment of the endoluminal prosthesis 60 illustrated in Figures 1OA, 1OB in the deployed or expanded state (i.e., after the outer sheath 84 of the catheter 78 has been retracted and of the endoluminal prosthesis 60 has been expanded). Figure 15 also shows the guidewires 80, 82 passing through the openings 64, 66 respectively. As can be seen in Figure 15, in some embodiments, the catheter 78 can have three lumens through at least a portion of the catheter 78, each of the three lumens configured to receive a guidewire. Having three lumens through at least a portion of the catheter 78 can prevent twisting of the guidewires, so as to ensure proper deployment.
[0095] As again illustrated in Figure 15, each of the 0.014 in guidewires 90, 92 can be passed through the hollow guidewires 80, 82, respectively. Therefore, before placing the endoluminal prosthesis 60 across the renal arteries, the guidewires 90, 92 can be maneuvered into the target vessels, as shown in Figure 14, which is a partial section view of a
patient's vasculature illustrating guidewires 90, 92 inserted through the abdominal aortic 94 and into the renal arteries 96, 98, respectively.
[0096] As illustrated in Figure 14, third guidewire 100 can be positioned in the aorta 94 at the same time that the 0.014 in guidewires 90, 92 can be placed in the left and the right renal arteries 96, 98, respectively. The delivery catheter 78 can then be passed over guidewire 100 into the aorta. The hollow guidewires 80, 82 of the delivery system can track over the guidewires 90, 92 into the renal arteries until the endoluminal prosthesis 60 is positioned in the desired location.
[0097] Figure 16 is a partial section view of a patient's vasculature illustrating the endoluminal prosthesis 60 deployed in the desired position within the patient's vasculature, after the components of the delivery catheter 78 except for the guidewires 80, 82 have been retracted from the patient's vasculature. As has been described, the hollow guidewire 80 can pass over the guidewire 90 through the opening 64 into the right renal artery 98. The hollow guidewire 82 can pass over the guidewire 92 through the opening 66 into the left renal artery 96.
[0098] In some embodiments, sutures or markers made from an RO material can be sewn into or attached to the endoluminal prosthesis 60 or any other prosthesis disclosed herein adjacent to the openings formed therein or at any other suitable location to assist the medical practitioner in visualizing the location of the prosthesis relative to the patient's vasculature. For example, without limitation, RO sutures can be sewn into the main body 62 of the endoluminal prosthesis 60 around each of the openings 64, 66 and/or near the end portion or portions of the main body 62. Alternatively, RO markers can be sewn to or otherwise attached to the main body of the endoluminal prosthesis 60 or any endoluminal prosthesis at any suitable position.
[0099] Figure 17 is a partial section view of a patient's vasculature illustrating the endoluminal prosthesis 60 illustrated in Figures 1OA, 1OB deployed in the desired position within the patient's vasculature, after all of the components of the delivery catheter 78 have been retracted from the patient's vasculature, including the hollow guidewires 80, 82. The guidewires 90, 92 can remain in position in the renal arteries. As illustrated in Figure 17, the first, smaller opening 64 of the endoluminal prosthesis 60 can be approximately aligned with
the right renal artery 98. As mentioned, the first opening 64 can approximately match the size of the opening into the right renal artery 98. Additionally, with reference to Figure 17, the second, larger opening 66 of the endoluminal prosthesis 60 can be positioned so that the main body 62 of the endoluminal prosthesis 60 does not cover or inhibit the flow of blood from the aortic artery 94 into the left renal artery 96.
[0100] Figure 18 is a partial section view of a patient's vasculature illustrating the endoluminal prosthesis 70 illustrated in Figures HA, HB also deployed in the desired position within the patient's vasculature, after the components of the delivery system except for the guidewires have been retracted from the patient's vasculature. In Figure 18, a second endoluminal prosthesis 70 has been positioned in the desired location in a similar fashion as has been described above with respect to the first endoluminal prosthesis 60. Again the hollow guidewires 102, 104 of the second delivery system can pass over the guidewires 90, 92, respectively. The opening 74 (which, again, can be relatively small as compared to opening 76) in the second endoluminal prosthesis 70 can be placed adjacent to the left renal artery 96. The opening 76 (which can be relatively large as compared to the first opening 74) in the second endoluminal prosthesis 70 can be placed adjacent to the right renal artery 98.
[0101] Figure 19 is a partial section view of a patient's vasculature illustrating both endoluminal prostheses 60, 70 positioned in the desired position within the patient's vasculature, after the components of the delivery system or systems have been retracted from the patient's vasculature. The small openings 64, 74 of the respective endoluminal prostheses 60, 70 provide fenestration to both renal arteries 98, 96, respectively. The overlapping endoluminal prostheses 60, 70 ensure a seal of the graft against the aorta. Thereafter, an expandable stent can be positioned and expanded within the endoluminal prostheses 60, 70, in a manner that is similar to the expandable stents described above, or in any suitable manner. While the prostheses 60, 70 are described as being self-expandable, in modified embodiments, one or both of the prostheses 60, 70 can be partially or wholly balloon expandable, or expandable by any other means.
[0102] Figure 20 is a perspective view of another embodiment of a fenestrated graft or endoluminal prosthesis 1 10 with a scalloped end portion. With reference to Figure 20, the endoluminal prosthesis 1 10 can have a main body 112, a first, smaller opening 114, a
second, larger opening 116, and one or more cutouts 118 (two being shown) formed at any desired location in an end portion of the main body 112 or at any location in the main body 1 12. In some embodiments, with the exception of the differences discussed herein and/or illustrated in Figure 20, other aspects of the endoluminal prosthesis 110 can be the same as or similar to any of the other endoluminal prostheses disclosed herein, including but not limited to the endoluminal prostheses 10, 60 disclosed herein. Furthermore, the endoluminal prosthesis 110 can be deployed and secured in the desired vascular location by any of the same methods as described above with respect to any other endoluminal prostheses, including but not limited to the endoluminal prostheses 10, 60. The one or more cutouts 118 can be sized and position so that the main body 1 12 of the endoluminal prosthesis 1 10 does not significantly obstruct the flow into any other branch arteries.
|0103] For example, the cutouts 118 can be advantageous when positioning the endoluminal prosthesis 110 in the vasculature below the SMA. Any of the endoluminal prostheses or other grafts disclosed in this application or incorporated by reference herein can be formed so as to comprise the one or more cutouts 118 illustrated in Figure 20. Again, in some embodiments, sutures or markers made from an RO material can be sewn into or attached to the endoluminal prosthesis 1 10 or any other prosthesis disclosed herein adjacent to one or more of the cutouts 118, one or more of the openings 114, 116 formed therein, near either of the end portions of the main body 1 12, or at any other suitable location.
[0104] Figure 21 is a perspective view of another embodiment of an endoluminal prosthesis 120. In some embodiments, certain aspects of the endoluminal prosthesis 120 can be the same as or similar to any of the other endoluminal prostheses disclosed herein, including but not limited to the endoluminal prostheses 10, 60, 1 10 disclosed herein. Similar to the prosthesis 10 illustrated in Figure IA, the endoluminal prosthesis 120 can have a main body 122 and a branch graft 124. Additionally, similar to the prosthesis 60 disclosed herein, the endoluminal prosthesis 120 can have a larger opening 126 formed in the main body 122 at any desired axial or radial position. In some embodiments, the larger opening 126 can be positioned on the main body 122 at a radial position that opposes the branch graft 124 such that the axial centerline of the larger opening 126 is approximately parallel to the axial centerline of the branch graft 124.
[0105] In some embodiments, the branch graft 124 can be integrally formed with or can be sutured, adhered, or otherwise attached to the main body 122 in place of the first, smaller opening 64 described above with reference to endoluminal prosthesis 60. Accordingly, in some embodiments, the endoluminal prosthesis 120 can be deployed in the same manner as or similar to the method described above for deploying the endoluminal prosthesis 60. Alternatively, the endoluminal prosthesis 120 can be deployed by any suitable method. Similar to the embodiment of the endoluminal prosthesis 1 10 illustrated in Figure 20, the endoluminal prosthesis 21 can also have one or more cutouts 118 (not shown) formed at any desired location in an end portion of the main body 122. Further, as with any other endoluminal prosthesis disclosed herein, in some embodiments, sutures or markers made from an RO material can be sewn into or attached to the endoluminal prosthesis 120 adjacent to one or more of the cutouts 118 (not illustrated), adjacent to the opening 126 formed in the main body 122, adjacent to or on the branch graft 124, near either of the end portions of the main body 112, and/or at any other suitable location.
[0106] With reference to Figures 22-27, a method of deploying the endoluminal prosthesis 120 will now be described. Figure 22 is a partial section view of a patient's vasculature after a first and second endoluminal prosthesis 120, 130 have been positioned within the patient's vasculature, after the components of the delivery system except for the hollow guidewires 80, 82 have been retracted from the patient's vasculature. In some embodiments, as illustrated in Figure 22, the second endoluminal prosthesis 130 can be the same as the first endoluminal prosthesis 120 described above. Further, with reference to Figure 22, the branch graft 124 of the first endoluminal prosthesis 120 can be positioned in the right renal artery 98, while the branch graft 134 of the second endoluminal prosthesis 130 can be positioned within the left renal artery 96.
[0107] Similar to the fenestrated endoluminal prostheses described above, each endoluminal prosthesis 120, 130 is independently positionable so as to accommodate a wide range of vasculature geometries or renal arteries without requiring a medical practitioner to custom make the endoluminal prosthesis. In some embodiments, the branch graft 124, 134 in the endoluminal prostheses 120, 130 can be sized to match the renal artery or branch vessel that the branch graft 124, 134 is intended to be inserted into. The position and size of the
second larger opening can be configured such that it accommodates a wide range of branch vessel configurations.
[0108] Similar to the deployment of the endoluminal prostheses 60, 70 described above, the guidewires 90, 92 can be used for positioning each of the endoluminal prostheses 120, 130, and for guiding the delivery catheter for each of the branch stents, as will be described below. Figures 23 and 24 are partial section views of a patient's vasculature illustrating the endoluminal prostheses 120, 130 deployed in the desired position within the patient's vasculature, further illustrating a branch graft deployment catheter 140 being guided into the right renal artery 98 over the guidewire 90. With reference to Figures 23 and 24, after the first and second endoluminal prostheses 120, 130 have been positioned in the desired location in the patient's vasculature, the branch graft deployment catheter 140 can be guided up the guide wire 90 into the right renal artery 98. Optionally, if the branch graft deployment catheter has a balloon supported by the distal end thereof, the balloon can be inflated to secure the branch graft deployment catheter within the renal artery, as discussed above. Additionally, in some embodiments, coils or hooks supported by the distal end of the branch graft deployment catheter can be used to secure the branch graft deployment catheter within the renal artery.
[0109] Once the deployment catheter 140 has reached the desired position such that the catheter tip 142 has extended past the end of the branch graft 124, as illustrated in Figure 24, the outer sheath 144 of the deployment catheter 140 can be retracted to deploy the stent 146 supported within the deployment catheter 140, as illustrated in Figure 25. The stent 146 illustrated in Figure 24 is a self expanding stent. However, the procedures disclosed herein can easily be modified to accommodate a balloon expandable or other stent suitable for such use.
[0110] As mentioned above, Figure 25 is a partial section view of a patient's vasculature illustrating an embodiment of a stent 146 being deployed in the branch graft 124 positioned in a patient's right renal artery 98 by proximally retracting the outer sheath 144 of the deployment catheter 140. Figure 26 illustrates the patient's vasculature after the stent 142 has been completely deployed in the branch graft 124 positioned in a patient's right renal artery 98. As illustrated therein, the expansion of the stent 146 can cause the branch graft
124 to expand against the blood vessel 98, so as to secure the graft 124 in the desired position. Note that, in some embodiments, the proximal portion of the branch graft 124 (i.e. a portion of the branch graft 124 closest to the main body 122 of the endoluminal prosthesis 120, as illustrated in Figure 25) can be pre-expanded to more approximately match the patient's vasculature in the pre-deployed state, as was described above with reference to endoluminal prosthesis 10.
[0111] Finally, Figure 27 is a partial section view of a patient's vasculature illustrating an embodiment of a stent 142 after it has been completely deployed in the branch graft 124 positioned in a patient's right renal artery 98, further illustrating the delivery catheter 140 being removed from the patient's vasculature. Following the procedures described in in connection with Figures 22-27, a stent similar to the stent 146 described above can be deployed in the branch graft 134 of the second endoluminal prosthesis 130, so that the branch graft 134 in the left renal artery 96 can be supported in the desired position.
[0112] Alternatively, the branch grafts 124, 134 can be expanded within the renal artery in a manner similar to any of the methods disclosed herein for expanding the branch graft 14 in the blood vessel or renal artery. Alternatively, the branch grafts 124, 134 can be expanded within the blood vessel or renal artery following any other suitable method, which can include deploying a self-expanding or balloon expandable bare metal stent or graft covered stent therein after the branch grafts 124, 134 have been positioned in the desired blood vessel or renal artery.
[0113] Additionally, any of the endoluminal prostheses described herein can be used independently or can be used in conjunction one or more additional grafts, including the grafts disclosed herein or any other suitable grafts such as other tubular or bifurcated grafts. For example, without limitation, any of the endoluminal prostheses disclosed herein or incorporated herein by reference, or either or both of the endoluminal prostheses 120, 130 can be used in conjunction with an additional prosthesis configured the same as or similar to the endoluminal prosthesis 120 to accommodate additional branch vessels, and/or any other suitable prostheses, such as without limitation a bifurcated prosthesis.
[0114] Additionally, without limitation, any of the endoluminal prostheses disclosed herein or incorporated herein by reference, or either or both of the endoluminal
prostheses 120, 130 can be used with any bifurcated graft positioned in a patient's vasculature to protect a patient's AAA. In this application, one or more of the endoluminal prostheses disclosed herein (including but not limited to endoluminal prostheses 10, 30, 40, 50, 60, 70, 110, and/or 120) can be deployed within the patient's vasculature after the bifurcated graft has been deployed across the patient's AAA. In this manner, the endoluminal prostheses disclosed herein will be positioned within the bifurcated graft it has been deployed across the patient's AAA so as to minimize or prevent blood from flowing between the main tubular portion of the bifurcated graft and the patient's blood vessel.
[0115] One of ordinary skill in the art will recognize many configurations of the fenestrated grafts described herein for the treatment of a main vessel having two or more branch vessels. As described herein, in some embodiments, the overlap of two or more portions of the endoluminal prostheses each having at least one small and one large opening can combine to create an endoluminal prosthesis system with two or more small openings, which can be used address a wide range of vasculature geometries without requiring any custom fabrication of the prostheses.
[0116] While the above detailed description has shown, described, and pointed out novel features as applied to various embodiments, it will be understood that various omissions, substitutions, and changes in the form and details of the device or process illustrated can be made without departing from the spirit of the disclosure. Additionally, the various features and processes described above can be used independently of one another, or can be combined in various ways. All possible combinations and subcombinations are intended to fall within the scope of this disclosure.
[0117] As will be recognized, certain embodiments described herein can be embodied within a form that does not provide all of the features and benefits set forth herein, as some features can be used or practiced separately from others. The scope of the inventions is indicated by the appended claims rather than by the foregoing description. All changes which come within the meaning and range of equivalency of the claims are to be embraced within their scope.
[0118] For example, while some embodiments of the delivery and graft systems are described herein with respect to the abdominal aortic artery, the delivery and graft
systems can be used for repairing vasculature in other portions of the body, including but not limited to the SMA, the inferior mesenteric artery, or any other arteries or blood vessels in the body suitable for such procedures or apparatuses.
Claims
1. An endoluminal prosthesis system comprising: a first endoluminal prosthesis comprising a first main graft body having at least a first and a second opening therein; and a second endoluminal prosthesis comprising a second main graft body having at least a first and a second opening therein; wherein: the first opening in the first main graft body is smaller than the second opening in the first main graft body; the first opening in the second main graft body is smaller than the second opening in the second main graft body; the second main graft body is configured to be expandable substantially within the first main graft body such that the second opening of the second main graft body does not cover any portion of the first opening in the first main graft body, and such that the second opening of the first main graft body does not cover any portion of the first opening in the second main graft body; and when the second main graft body has been expanded within the first main graft body, the resulting endoluminal prosthesis system has two small openings therein that are each approximately equivalent in diameter to the first opening in each of the first and second main graft bodies.
2. The endoluminal prosthesis system of Claim 1 , wherein the main graft body of each of the first and second endoluminal prostheses defines a generally tubular shape.
3. The endoluminal prosthesis system of Claim 1, wherein the first opening in at least one of the first and second main graft bodies is approximately diametrically opposed to the second opening in the same main graft body.
4. The endoluminal prosthesis system of Claim 1, wherein the first opening in each of the first and second main graft bodies is significantly smaller than the second opening in each of the first and second main graft bodies.
5. The endoluminal prosthesis system of Claim 1, wherein the second opening in each of the first and second main graft bodies defines a diameter that is at least approximately three times greater than the diameter of the first opening in each of the first and second main graft bodies.
6. The endoluminal prosthesis system of Claim 1, wherein the second opening in each of the first and second main graft bodies defines a diameter that is at least approximately four times greater than the diameter of the first opening in each of the first and second main graft bodies.
7. The endoluminal prosthesis system of Claim 1, wherein the two small openings in the resulting endoluminal prosthesis system are not mutually opposing.
8. The endoluminal prosthesis system of Claim 1, wherein at least one of the first and second main graft bodies comprises one or more cutouts in an end portion thereof.
9. The endoluminal prosthesis system of Claim 1, wherein the first opening in the first main graft body comprises a branch graft attached to the first main graft body so as to surround the first opening in the first main graft body.
10. The endoluminal prosthesis system of Claim 9, wherein the branch graft attached to the first main graft body is expandable with a bare or covered metal stent.
1 1. The endoluminal prosthesis system of Claim 9, wherein the first opening in the second main graft body comprises a branch graft attached to the second main graft body so as to surround the first opening in the second main graft body.
12. The endoluminal prosthesis system of Claim 11, wherein at least one of the branch graft attached to the first main graft body and the branch graft attached to the second main graft body is expandable with a bare or covered metal stent.
13. The endoluminal prosthesis system of Claim 1, further comprising a third endoluminal prosthesis positioned adjacent to or overlapping with at least a portion of one of the first endoluminal prosthesis and the second endoluminal prosthesis.
14. The endoluminal prosthesis system of Claim 13, wherein the third prosthesis is a bifurcated endoluminal prosthesis.
15. The endoluminal prosthesis system of Claim 13, wherein the third prosthesis is a bifurcated endoluminal prosthesis configured to be positioned adjacent to an abdominal aortic aneurysm.
16. The endoluminal prosthesis system of Claim 13, wherein the third prosthesis comprises a third main graft body having at least a first and a second opening therein, wherein the third main graft body is configured such that at least a portion of the third main body is expandable within the second main graft body.
17. The endoluminal prosthesis system of Claim 1, wherein at least one of the first endoluminal prosthesis and the second endoluminal prosthesis comprises a distensible polymeric material.
18. The endoluminal prosthesis system of Claim 17, wherein the polymeric material is selected from the group consisting of PTFE, ePTFE, Dacron, Dacron.RTM, Teflon.RTM, and polyester.
19. The endoluminal prosthesis system of Claim 1 , wherein at least one of the first endoluminal prosthesis and the second endoluminal prosthesis has at least one radiopaque suture or marker attached thereto.
20. A method of deploying a branch graft system in a portion of a patient's blood vessel having at least a first and a second branch blood vessel, comprising: positioning a first main graft body having at least a first and a second opening therein in the patient's blood vessel so that the first opening is substantially aligned with the first branch blood vessel and so that the second opening is sufficiently aligned with the second branch blood vessel so that the first main graft body does not substantially cover either the first or second branch blood vessel; positioning at least a portion of a second main graft body having at least a first and a second opening therein within the inside of the first main graft body so that the first opening of the second main graft body is substantially aligned with the second branch blood vessel and so that the second opening of the second main graft body is sufficiently aligned with the first branch blood vessel so that the second main graft body does not substantially cover either the first or second branch blood vessel; wherein: the second opening in each of the first and second main graft bodies is substantially larger than the first opening in each of the first and second main graft bodies; expanding the first and second main graft bodies against the patient's blood vessel to create a multi-layer graft system having two openings through the wall thereof that are substantially aligned with the first and second blood vessels and have a diameter substantially equal to the first opening of each of the first and second main graft bodies; and supporting the first and second main graft bodies against the patient's blood vessel.
21. The method of deploying a branch graft system of Claim 20, wherein the first main graft body is expanded against the patient's blood vessel before a portion of the second main graft body is positioned within the first main graft body.
22. The method of deploying a branch graft system of Claim 20, wherein supporting the first and second main graft bodies against the patient's blood vessel comprises deploying a bare metal or covered stent against the inside surface of at least the second main graft body.
23. The method of deploying a branch graft system of Claim 20, wherein a hollow guidewire is placed inside at least one of the first and second openings of the first main graft body before positioning the first main graft body in the patient's blood vessel.
24. The method of deploying a branch graft system of Claim 20, wherein a hollow guidewire is placed inside at least one of the first and second openings of the second main graft body before positioning the second main graft body in the patient's blood vessel.
25. The method of deploying a branch graft system of Claim 20, wherein a deployment catheter having three lumens therethrough is used for positioning the first main graft body in the patient's blood vessel.
26. The method of deploying a branch graft system of Claim 20, wherein the first main graft body further comprises a first branch graft attached to the first main graft body so as to surround the first opening in the first main graft body.
27. The method of deploying a branch graft system of Claim 26, wherein the first branch graft is expanded within the first branch blood vessel before positioning at least a portion of the second main graft body within the inside of the first main graft body.
28. The method of deploying a branch graft system of Claim 26, wherein the first branch graft is expanded within the first branch blood vessel with a self-expanding stent before positioning at least a portion of the second main graft body within the inside of the first main graft body.
29. The method of deploying a branch graft system of Claim 26, wherein the second main graft body further comprises a second branch graft attached to the second main graft body so as to surround the first opening in the second main graft body.
30. The method of deploying a branch graft system of Claim 29, wherein the second branch graft is expanded within the second branch blood vessel after positioning at least a portion of the second main graft body within the inside of the first main graft body.
31. The method of deploying a branch graft system of Claim 29, wherein the second branch graft is expanded within the second branch blood vessel with a self-expanding stent after positioning at least a portion of the second main graft body within the inside of the first main graft body.
32. The method of deploying a branch graft system of Claim 20, wherein at least one of the first main graft and second main graft are positioned in the patient's blood vessel using one or more guidewires.
33. The method of deploying a branch graft system of Claim 32, wherein a distal end portion of at least one of the one or more guidewires is configured to be secured to the first branch blood vessel or the second branch blood vessel.
34. The method of deploying a branch graft system of Claim 33, wherein the distal end portion of at least one of the one or more guidewires comprises an inflatable balloon, a hooks, or a coil configured to secure at least the end portion of the guidewire within the first or the second branch blood vessel.
35. An endoluminal prosthesis comprising: an expandable main graft portion having an axial opening therethrough and at least a first branch opening therein; and an expandable branch graft portion having a proximal end portion, a distal end portion, and an axial opening therethrough; wherein: the branch graft portion is supported by the main graft portion; the branch graft portion is supported by the main graft portion so that the proximal end portion of the branch graft portion is positioned around a periphery of the first branch opening in the main graft, and such that the axial opening through the branch graft portion is in communication with the first branch opening formed in the main graft portion; and at least the distal end portion of the branch graft portion is unexpanded.
36. The endoluminal prosthesis of Claim 35, wherein the distal end portion of the branch graft portion is expandable in a branch blood vessel to a diameter that is approximately equal to the diameter of the proximal end portion of the branch graft portion.
37. The endoluminal prosthesis of Claim 35, wherein the distal end portion of the branch graft portion is expandable in a branch blood vessel using a stent.
38. The endoluminal prosthesis of Claim 35, wherein the distal end portion of the branch graft portion is expandable in a branch blood vessel using a balloon expander.
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Cited By (8)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
WO2012061526A3 (en) * | 2010-11-02 | 2012-08-23 | Endologix, Inc. | Apparatus and method of placement of a graft or graft system |
EP2693979A2 (en) * | 2011-04-19 | 2014-02-12 | Myles Douglas | Branch endograft delivery |
US9149381B2 (en) | 2008-02-22 | 2015-10-06 | Endologix, Inc. | Apparatus and method of placement of a graft or graft system |
WO2016096529A1 (en) * | 2014-12-18 | 2016-06-23 | Intellistent Ag | Stent and kit of stents for adjustable interventional reduction of blood flow |
EP2823846B1 (en) * | 2010-11-15 | 2016-12-07 | Endovascular Development AB | A tubular element |
US9662232B2 (en) | 2014-04-11 | 2017-05-30 | Red Vascular Technologies, LLC | Alignment system for multiple branch endografts |
US10603196B2 (en) | 2009-04-28 | 2020-03-31 | Endologix, Inc. | Fenestrated prosthesis |
US11129737B2 (en) | 2015-06-30 | 2021-09-28 | Endologix Llc | Locking assembly for coupling guidewire to delivery system |
Families Citing this family (45)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US8034100B2 (en) | 1999-03-11 | 2011-10-11 | Endologix, Inc. | Graft deployment system |
US7147661B2 (en) | 2001-12-20 | 2006-12-12 | Boston Scientific Santa Rosa Corp. | Radially expandable stent |
US8236040B2 (en) | 2008-04-11 | 2012-08-07 | Endologix, Inc. | Bifurcated graft deployment systems and methods |
JP5134729B2 (en) | 2008-07-01 | 2013-01-30 | エンドロジックス、インク | Catheter system |
US9050184B2 (en) * | 2008-08-13 | 2015-06-09 | Allergan, Inc. | Dual plane breast implant |
US9579103B2 (en) | 2009-05-01 | 2017-02-28 | Endologix, Inc. | Percutaneous method and device to treat dissections |
US10772717B2 (en) | 2009-05-01 | 2020-09-15 | Endologix, Inc. | Percutaneous method and device to treat dissections |
CA3009244C (en) | 2009-06-23 | 2020-04-28 | Endospan Ltd. | Vascular prostheses for treating aneurysms |
WO2011017123A2 (en) | 2009-07-27 | 2011-02-10 | Endologix, Inc. | Stent graft |
US9211183B2 (en) * | 2009-10-02 | 2015-12-15 | Cook Medical Technologies Llc | Thoracic stent graft with guide arrangement |
EP3735937A1 (en) | 2009-11-30 | 2020-11-11 | Endospan Ltd. | Multi-component stent-graft system for implantation in a blood vessel with multiple branches |
WO2011070576A1 (en) | 2009-12-08 | 2011-06-16 | Endospan Ltd. | Endovascular stent-graft system with fenestrated and crossing stent-grafts |
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US9381078B2 (en) * | 2011-04-29 | 2016-07-05 | The Cleveland Clinic Foundation | Power and/or signal trigger wire for an endovascular delivery system |
US10813630B2 (en) | 2011-08-09 | 2020-10-27 | Corquest Medical, Inc. | Closure system for atrial wall |
US10307167B2 (en) | 2012-12-14 | 2019-06-04 | Corquest Medical, Inc. | Assembly and method for left atrial appendage occlusion |
US10314594B2 (en) | 2012-12-14 | 2019-06-11 | Corquest Medical, Inc. | Assembly and method for left atrial appendage occlusion |
US9839510B2 (en) | 2011-08-28 | 2017-12-12 | Endospan Ltd. | Stent-grafts with post-deployment variable radial displacement |
US9427339B2 (en) | 2011-10-30 | 2016-08-30 | Endospan Ltd. | Triple-collar stent-graft |
US9597204B2 (en) | 2011-12-04 | 2017-03-21 | Endospan Ltd. | Branched stent-graft system |
WO2013171730A1 (en) | 2012-05-15 | 2013-11-21 | Endospan Ltd. | Stent-graft with fixation elements that are radially confined for delivery |
US20140018902A1 (en) * | 2012-07-12 | 2014-01-16 | Makor Issues And Rights Ltd. | Tailor-made stent graft and procedure for minimally invasive aneurysm repair with novel tailor-made balloon, novel guidewire, and novel capsulated bioglue |
US20140142689A1 (en) | 2012-11-21 | 2014-05-22 | Didier De Canniere | Device and method of treating heart valve malfunction |
US9498362B2 (en) * | 2013-02-19 | 2016-11-22 | Colin Pearce | Wedge wire for use with a narrowed bifurcation vessel |
EP2967830B1 (en) | 2013-03-11 | 2017-11-01 | Endospan Ltd. | Multi-component stent-graft system for aortic dissections |
US20140277347A1 (en) * | 2013-03-15 | 2014-09-18 | W. L. Gore & Associates, Inc. | Endoprosthetic device comprising a support channel capapble of receiving a branch endoprosthetic device |
WO2015075708A1 (en) | 2013-11-19 | 2015-05-28 | Endospan Ltd. | Stent system with radial-expansion locking |
US9782195B2 (en) | 2013-11-20 | 2017-10-10 | Board Of Regents Of The University Of Nebraska | Fluid jet arterial surgical device |
US9566443B2 (en) | 2013-11-26 | 2017-02-14 | Corquest Medical, Inc. | System for treating heart valve malfunction including mitral regurgitation |
US8998971B1 (en) * | 2014-01-28 | 2015-04-07 | Sanford Health | Pararenal stent graft and methods for use |
US9974671B2 (en) * | 2014-11-03 | 2018-05-22 | Medtronic Vascular, Inc. | Devices and methods for treating aneurysms and other vascular conditions |
US10842626B2 (en) | 2014-12-09 | 2020-11-24 | Didier De Canniere | Intracardiac device to correct mitral regurgitation |
WO2016098113A1 (en) | 2014-12-18 | 2016-06-23 | Endospan Ltd. | Endovascular stent-graft with fatigue-resistant lateral tube |
US9907680B2 (en) * | 2015-04-10 | 2018-03-06 | Cook Medical Technologies Llc | Sliding fenestration |
WO2017015498A1 (en) | 2015-07-22 | 2017-01-26 | Nitinol Devices And Components, Inc. | Graft dimpling to improve crimp profile and reduce delivery forces |
US10905540B2 (en) | 2015-11-12 | 2021-02-02 | Endospan Ltd. | Stent-grafts systems with skirt |
US10512533B1 (en) | 2016-02-23 | 2019-12-24 | W. L. Gore & Associates, Inc. | Branched graft assembly method in vivo |
US10433852B2 (en) | 2017-05-08 | 2019-10-08 | William Z. H'Doubler | Aortic occlusion balloon apparatus, system and method of making |
CN111148484B (en) | 2017-09-25 | 2022-12-30 | 波尔顿医疗公司 | Systems, devices, and methods for coupling a prosthetic implant to an open window |
US10629391B2 (en) | 2017-12-21 | 2020-04-21 | Eaton Intelligent Power Limited | Fusible safety disconnect in solid state circuit breakers and combination motor starters |
US10925711B2 (en) * | 2018-04-11 | 2021-02-23 | Cook Medical Technologies Llc | Branch graft system with adjustable openings |
JP2022525788A (en) | 2019-03-20 | 2022-05-19 | インキュベート メディカル テクノロジーズ、 エルエルシー | Aortic dissection implant |
JP1651803S (en) * | 2019-04-15 | 2020-02-03 | syringe cap | |
USD1016289S1 (en) * | 2022-01-18 | 2024-02-27 | Sutherland Cardiovascular Ltd. | Aortic root replacement graft |
WO2024057320A1 (en) | 2022-09-15 | 2024-03-21 | Endospan Ltd. | Double-branching ascending aortic stent-graft systems |
Citations (4)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US20020147491A1 (en) * | 1999-11-22 | 2002-10-10 | Khan I. John | Stent delivery system having a fixed guidewire |
US20060155358A1 (en) * | 2005-01-10 | 2006-07-13 | Laduca Robert | Methods for placing a stent in a branched vessel |
US20070260304A1 (en) * | 2006-05-02 | 2007-11-08 | Daniel Gregorich | Bifurcated stent with minimally circumferentially projected side branch |
US20070299497A1 (en) * | 1998-12-11 | 2007-12-27 | Endologix, Inc. | Implantable vascular graft |
Family Cites Families (670)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US2127903A (en) | 1936-05-05 | 1938-08-23 | Davis & Geck Inc | Tube for surgical purposes and method of preparing and using the same |
US2437542A (en) | 1944-05-05 | 1948-03-09 | American Catheter Corp | Catheter-type instrument |
US2845959A (en) | 1956-03-26 | 1958-08-05 | John B Sidebotham | Bifurcated textile tubes and method of weaving the same |
US2990605A (en) | 1957-01-30 | 1961-07-04 | Demsyk Paul | Method of forming artificial vascular members |
US3096560A (en) | 1958-11-21 | 1963-07-09 | William J Liebig | Process for synthetic vascular implants |
US3029819A (en) | 1959-07-30 | 1962-04-17 | J L Mcatee | Artery graft and method of producing artery grafts |
US3805301A (en) | 1972-07-28 | 1974-04-23 | Meadox Medicals Inc | Tubular grafts having indicia thereon |
SE395627B (en) | 1974-06-07 | 1977-08-22 | Asea Ab | PRESSURE FOR HYDROSTATIC EXTENSION OF TUBE |
US6436135B1 (en) | 1974-10-24 | 2002-08-20 | David Goldfarb | Prosthetic vascular graft |
DE2760437C2 (en) | 1976-04-05 | 1990-03-22 | Agence Nationale De Valorisation De La Recherche (Anvar), Paris, Fr | |
US4362156A (en) | 1979-04-18 | 1982-12-07 | Riverain Corporation | Intravenous infusion assembly |
US4503568A (en) | 1981-11-25 | 1985-03-12 | New England Deaconess Hospital | Small diameter vascular bypass and method |
US4501263A (en) | 1982-03-31 | 1985-02-26 | Harbuck Stanley C | Method for reducing hypertension of a liver |
US4473067A (en) | 1982-04-28 | 1984-09-25 | Peter Schiff | Introducer assembly for intra-aortic balloons and the like incorporating a sliding, blood-tight seal |
US4512338A (en) | 1983-01-25 | 1985-04-23 | Balko Alexander B | Process for restoring patency to body vessels |
US4525157A (en) | 1983-07-28 | 1985-06-25 | Manresa, Inc. | Closed system catheter with guide wire |
US4592754A (en) | 1983-09-09 | 1986-06-03 | Gupte Pradeep M | Surgical prosthetic vessel graft and catheter combination and method |
US5669936A (en) | 1983-12-09 | 1997-09-23 | Endovascular Technologies, Inc. | Endovascular grafting system and method for use therewith |
US6221102B1 (en) | 1983-12-09 | 2001-04-24 | Endovascular Technologies, Inc. | Intraluminal grafting system |
US5693083A (en) | 1983-12-09 | 1997-12-02 | Endovascular Technologies, Inc. | Thoracic graft and delivery catheter |
US5275622A (en) | 1983-12-09 | 1994-01-04 | Harrison Medical Technologies, Inc. | Endovascular grafting apparatus, system and method and devices for use therewith |
US5104399A (en) | 1986-12-10 | 1992-04-14 | Endovascular Technologies, Inc. | Artificial graft and implantation method |
US5108424A (en) | 1984-01-30 | 1992-04-28 | Meadox Medicals, Inc. | Collagen-impregnated dacron graft |
US4617932A (en) | 1984-04-25 | 1986-10-21 | Elliot Kornberg | Device and method for performing an intraluminal abdominal aortic aneurysm repair |
US4562596A (en) * | 1984-04-25 | 1986-01-07 | Elliot Kornberg | Aortic graft, device and method for performing an intraluminal abdominal aortic aneurysm repair |
US4580568A (en) | 1984-10-01 | 1986-04-08 | Cook, Incorporated | Percutaneous endovascular stent and method for insertion thereof |
DE3640745A1 (en) | 1985-11-30 | 1987-06-04 | Ernst Peter Prof Dr M Strecker | Catheter for producing or extending connections to or between body cavities |
US4878906A (en) | 1986-03-25 | 1989-11-07 | Servetus Partnership | Endoprosthesis for repairing a damaged vessel |
US4756307A (en) | 1987-02-09 | 1988-07-12 | Zimmer, Inc. | Nail device |
US4907336A (en) | 1987-03-13 | 1990-03-13 | Cook Incorporated | Method of making an endovascular stent and delivery system |
US4800882A (en) | 1987-03-13 | 1989-01-31 | Cook Incorporated | Endovascular stent and delivery system |
IT1210722B (en) | 1987-05-11 | 1989-09-20 | Sorin Biomedica Spa | DEVICES FOR THE CONDITIONING OF BLOOD FLOWS |
US4795465A (en) * | 1987-05-14 | 1989-01-03 | Hood Laboratories | Tracheobronchial stent |
US4816028A (en) | 1987-07-01 | 1989-03-28 | Indu Kapadia | Woven vascular graft |
US5133732A (en) | 1987-10-19 | 1992-07-28 | Medtronic, Inc. | Intravascular stent |
US4840940A (en) | 1987-10-21 | 1989-06-20 | Sottiurai Vikrom S | Method for reducing the occurrence of distal anastomotic intimal hyperplasia using fractionated heparin |
JPH0784524B2 (en) | 1987-12-24 | 1995-09-13 | 東ソー株式会社 | Method for producing aromatic sulfide amide polymer |
US5019090A (en) | 1988-09-01 | 1991-05-28 | Corvita Corporation | Radially expandable endoprosthesis and the like |
US4981478A (en) | 1988-09-06 | 1991-01-01 | Advanced Cardiovascular Systems | Composite vascular catheter |
US4994069A (en) | 1988-11-02 | 1991-02-19 | Target Therapeutics | Vaso-occlusion coil and method |
US4856516A (en) | 1989-01-09 | 1989-08-15 | Cordis Corporation | Endovascular stent apparatus and method |
CH678393A5 (en) | 1989-01-26 | 1991-09-13 | Ulrich Prof Dr Med Sigwart | |
US5078726A (en) | 1989-02-01 | 1992-01-07 | Kreamer Jeffry W | Graft stent and method of repairing blood vessels |
US5178634A (en) * | 1989-03-31 | 1993-01-12 | Wilson Ramos Martinez | Aortic valved tubes for human implants |
US4994071A (en) | 1989-05-22 | 1991-02-19 | Cordis Corporation | Bifurcating stent apparatus and method |
US5571169A (en) | 1993-06-07 | 1996-11-05 | Endovascular Instruments, Inc. | Anti-stenotic method and product for occluded and partially occluded arteries |
US5662701A (en) | 1989-08-18 | 1997-09-02 | Endovascular Instruments, Inc. | Anti-stenotic method and product for occluded and partially occluded arteries |
US5035706A (en) | 1989-10-17 | 1991-07-30 | Cook Incorporated | Percutaneous stent and method for retrieval thereof |
US5123917A (en) | 1990-04-27 | 1992-06-23 | Lee Peter Y | Expandable intraluminal vascular graft |
JPH0425755A (en) | 1990-05-22 | 1992-01-29 | Japan Electron Control Syst Co Ltd | Oxygen sensor |
US5116349A (en) | 1990-05-23 | 1992-05-26 | United States Surgical Corporation | Surgical fastener apparatus |
US5360443A (en) | 1990-06-11 | 1994-11-01 | Barone Hector D | Aortic graft for repairing an abdominal aortic aneurysm |
US5578071A (en) | 1990-06-11 | 1996-11-26 | Parodi; Juan C. | Aortic graft |
US5156619A (en) | 1990-06-15 | 1992-10-20 | Ehrenfeld William K | Flanged end-to-side vascular graft |
US5064435A (en) | 1990-06-28 | 1991-11-12 | Schneider (Usa) Inc. | Self-expanding prosthesis having stable axial length |
DE9116881U1 (en) | 1990-10-09 | 1994-07-07 | Cook Inc | Percutaneous stent |
JPH0717314Y2 (en) | 1990-10-18 | 1995-04-26 | ソン ホーヨン | Self-expanding intravascular stent |
CA2060067A1 (en) | 1991-01-28 | 1992-07-29 | Lilip Lau | Stent delivery system |
US5135536A (en) | 1991-02-05 | 1992-08-04 | Cordis Corporation | Endovascular stent and method |
US5669934A (en) | 1991-02-13 | 1997-09-23 | Fusion Medical Technologies, Inc. | Methods for joining tissue by applying radiofrequency energy to performed collagen films and sheets |
CA2202800A1 (en) | 1991-04-11 | 1992-10-12 | Alec A. Piplani | Endovascular graft having bifurcation and apparatus and method for deploying the same |
US5628783A (en) | 1991-04-11 | 1997-05-13 | Endovascular Technologies, Inc. | Bifurcated multicapsule intraluminal grafting system and method |
US5158545A (en) | 1991-05-02 | 1992-10-27 | Brigham And Women's Hospital | Diameter expansion cannula |
US5554118A (en) | 1991-05-24 | 1996-09-10 | Jang; G. David | Universal mode vascular catheter system |
US5304200A (en) | 1991-05-29 | 1994-04-19 | Cordis Corporation | Welded radially expandable endoprosthesis and the like |
US5135535A (en) | 1991-06-11 | 1992-08-04 | Advanced Cardiovascular Systems, Inc. | Catheter system with catheter and guidewire exchange |
US5314472A (en) | 1991-10-01 | 1994-05-24 | Cook Incorporated | Vascular stent |
US5282478A (en) | 1991-08-21 | 1994-02-01 | Baxter International, Inc. | Guidewire extension system with coil connectors |
US5415178A (en) | 1991-08-26 | 1995-05-16 | Target Therapeutics | Extendable guidewire assembly |
US5197976A (en) | 1991-09-16 | 1993-03-30 | Atrium Medical Corporation | Manually separable multi-lumen vascular graft |
US5443498A (en) | 1991-10-01 | 1995-08-22 | Cook Incorporated | Vascular stent and method of making and implanting a vacsular stent |
US5464450A (en) | 1991-10-04 | 1995-11-07 | Scimed Lifesystems Inc. | Biodegradable drug delivery vascular stent |
US5151105A (en) | 1991-10-07 | 1992-09-29 | Kwan Gett Clifford | Collapsible vessel sleeve implant |
US5366504A (en) | 1992-05-20 | 1994-11-22 | Boston Scientific Corporation | Tubular medical prosthesis |
US5282860A (en) | 1991-10-16 | 1994-02-01 | Olympus Optical Co., Ltd. | Stent tube for medical use |
EP0539237A1 (en) | 1991-10-25 | 1993-04-28 | Cook Incorporated | Expandable transluminal graft prosthesis for repair of aneurysm and method for implanting |
US5720776A (en) | 1991-10-25 | 1998-02-24 | Cook Incorporated | Barb and expandable transluminal graft prosthesis for repair of aneurysm |
US5693084A (en) | 1991-10-25 | 1997-12-02 | Cook Incorporated | Expandable transluminal graft prosthesis for repair of aneurysm |
US5387235A (en) | 1991-10-25 | 1995-02-07 | Cook Incorporated | Expandable transluminal graft prosthesis for repair of aneurysm |
US5211658A (en) | 1991-11-05 | 1993-05-18 | New England Deaconess Hospital Corporation | Method and device for performing endovascular repair of aneurysms |
US5316023A (en) | 1992-01-08 | 1994-05-31 | Expandable Grafts Partnership | Method for bilateral intra-aortic bypass |
US5507767A (en) | 1992-01-15 | 1996-04-16 | Cook Incorporated | Spiral stent |
US5683448A (en) | 1992-02-21 | 1997-11-04 | Boston Scientific Technology, Inc. | Intraluminal stent and graft |
US5405377A (en) | 1992-02-21 | 1995-04-11 | Endotech Ltd. | Intraluminal stent |
US5282823A (en) | 1992-03-19 | 1994-02-01 | Medtronic, Inc. | Intravascular radially expandable stent |
US5370683A (en) | 1992-03-25 | 1994-12-06 | Cook Incorporated | Vascular stent |
US5201757A (en) | 1992-04-03 | 1993-04-13 | Schneider (Usa) Inc. | Medial region deployment of radially self-expanding stents |
US5263932A (en) | 1992-04-09 | 1993-11-23 | Jang G David | Bailout catheter for fixed wire angioplasty |
US5246452A (en) | 1992-04-13 | 1993-09-21 | Impra, Inc. | Vascular graft with removable sheath |
US5354308A (en) | 1992-05-01 | 1994-10-11 | Beth Israel Hospital Association | Metal wire stent |
US5817102A (en) | 1992-05-08 | 1998-10-06 | Schneider (Usa) Inc. | Apparatus for delivering and deploying a stent |
US5405378A (en) | 1992-05-20 | 1995-04-11 | Strecker; Ernst P. | Device with a prosthesis implantable in the body of a patient |
US5507771A (en) | 1992-06-15 | 1996-04-16 | Cook Incorporated | Stent assembly |
US5342387A (en) | 1992-06-18 | 1994-08-30 | American Biomed, Inc. | Artificial support for a blood vessel |
US5496365A (en) | 1992-07-02 | 1996-03-05 | Sgro; Jean-Claude | Autoexpandable vascular endoprosthesis |
US5643339A (en) | 1992-08-06 | 1997-07-01 | William Cook Europe A/S | Prosthetic device for sustaining a blood-vessel or hollow organ lumen |
DE59206251D1 (en) | 1992-10-31 | 1996-06-13 | Schneider Europ Ag | Arrangement for implanting self-expanding endoprostheses |
BE1006440A3 (en) | 1992-12-21 | 1994-08-30 | Dereume Jean Pierre Georges Em | Luminal endoprosthesis AND METHOD OF PREPARATION. |
US5256141A (en) | 1992-12-22 | 1993-10-26 | Nelson Gencheff | Biological material deployment method and apparatus |
EP0676936A1 (en) | 1992-12-30 | 1995-10-18 | Schneider (Usa) Inc. | Apparatus for deploying body implantable stents |
US5523092A (en) | 1993-04-14 | 1996-06-04 | Emory University | Device for local drug delivery and methods for using the same |
AU689094B2 (en) | 1993-04-22 | 1998-03-26 | C.R. Bard Inc. | Non-migrating vascular prosthesis and minimally invasive placement system therefor |
US5843167A (en) | 1993-04-22 | 1998-12-01 | C. R. Bard, Inc. | Method and apparatus for recapture of hooked endoprosthesis |
WO1994024961A1 (en) | 1993-04-23 | 1994-11-10 | Schneider (Usa) Inc. | Covered stent and stent delivery device |
EP0621015B1 (en) | 1993-04-23 | 1998-03-18 | Schneider (Europe) Ag | Stent with a covering layer of elastic material and method for applying the layer on the stent |
US5464650A (en) | 1993-04-26 | 1995-11-07 | Medtronic, Inc. | Intravascular stent and method |
US5643171A (en) | 1993-05-04 | 1997-07-01 | Neocardia, Llc | Method and apparatus for uniform radiation treatment of vascular lumens |
US5320602A (en) | 1993-05-14 | 1994-06-14 | Wilson-Cook Medical, Inc. | Peel-away endoscopic retrograde cholangio pancreatography catheter and a method for using the same |
US5414664A (en) | 1993-05-28 | 1995-05-09 | Macronix International Co., Ltd. | Flash EPROM with block erase flags for over-erase protection |
US5425765A (en) | 1993-06-25 | 1995-06-20 | Tiefenbrun; Jonathan | Surgical bypass method |
US5458615A (en) | 1993-07-06 | 1995-10-17 | Advanced Cardiovascular Systems, Inc. | Stent delivery system |
US5464449A (en) * | 1993-07-08 | 1995-11-07 | Thomas J. Fogarty | Internal graft prosthesis and delivery system |
CA2125258C (en) | 1993-08-05 | 1998-12-22 | Dinah B Quiachon | Multicapsule intraluminal grafting system and method |
AU6987594A (en) | 1993-08-18 | 1995-03-14 | W.L. Gore & Associates, Inc. | A tubular intraluminal graft |
US6027779A (en) | 1993-08-18 | 2000-02-22 | W. L. Gore & Associates, Inc. | Thin-wall polytetrafluoroethylene tube |
US5735892A (en) | 1993-08-18 | 1998-04-07 | W. L. Gore & Associates, Inc. | Intraluminal stent graft |
US6159565A (en) | 1993-08-18 | 2000-12-12 | W. L. Gore & Associates, Inc. | Thin-wall intraluminal graft |
US5669880A (en) | 1993-08-24 | 1997-09-23 | Cordis Corporation | Stent delivery system |
KR970004845Y1 (en) | 1993-09-27 | 1997-05-21 | 주식회사 수호메디테크 | Stent for expanding a lumen |
WO1995008966A1 (en) * | 1993-09-30 | 1995-04-06 | White Geoffrey H | Intraluminal graft |
EP0659389B1 (en) | 1993-10-20 | 1998-04-22 | Schneider (Europe) Ag | Endoprothese |
US5723004A (en) | 1993-10-21 | 1998-03-03 | Corvita Corporation | Expandable supportive endoluminal grafts |
US5632772A (en) | 1993-10-21 | 1997-05-27 | Corvita Corporation | Expandable supportive branched endoluminal grafts |
US5639278A (en) | 1993-10-21 | 1997-06-17 | Corvita Corporation | Expandable supportive bifurcated endoluminal grafts |
US5989280A (en) | 1993-10-22 | 1999-11-23 | Scimed Lifesystems, Inc | Stent delivery apparatus and method |
EP0657147B1 (en) | 1993-11-04 | 1999-08-04 | C.R. Bard, Inc. | Non-migrating vascular prosthesis |
AU1091095A (en) | 1993-11-08 | 1995-05-29 | Harrison M. Lazarus | Intraluminal vascular graft and method |
DE9319267U1 (en) | 1993-12-15 | 1994-02-24 | Vorwerk Dierk Dr | Aortic endoprosthesis |
JP2703510B2 (en) | 1993-12-28 | 1998-01-26 | アドヴァンスド カーディオヴァスキュラー システムズ インコーポレーテッド | Expandable stent and method of manufacturing the same |
US5403341A (en) | 1994-01-24 | 1995-04-04 | Solar; Ronald J. | Parallel flow endovascular stent and deployment apparatus therefore |
US5549635A (en) | 1994-01-24 | 1996-08-27 | Solar, Rita & Gaterud, Ltd. | Non-deformable self-expanding parallel flow endovascular stent and deployment apparatus therefore |
CA2160022C (en) | 1994-02-07 | 2005-01-18 | Keiji Igaki | Stent device and stent supplying system |
US5609627A (en) | 1994-02-09 | 1997-03-11 | Boston Scientific Technology, Inc. | Method for delivering a bifurcated endoluminal prosthesis |
US6051020A (en) | 1994-02-09 | 2000-04-18 | Boston Scientific Technology, Inc. | Bifurcated endoluminal prosthesis |
US5507769A (en) | 1994-10-18 | 1996-04-16 | Stentco, Inc. | Method and apparatus for forming an endoluminal bifurcated graft |
US6039749A (en) | 1994-02-10 | 2000-03-21 | Endovascular Systems, Inc. | Method and apparatus for deploying non-circular stents and graftstent complexes |
US5443477A (en) | 1994-02-10 | 1995-08-22 | Stentco, Inc. | Apparatus and method for deployment of radially expandable stents by a mechanical linkage |
US5453090A (en) | 1994-03-01 | 1995-09-26 | Cordis Corporation | Method of stent delivery through an elongate softenable sheath |
US5653746A (en) | 1994-03-08 | 1997-08-05 | Meadox Medicals, Inc. | Radially expandable tubular prosthesis |
US5415664A (en) | 1994-03-30 | 1995-05-16 | Corvita Corporation | Method and apparatus for introducing a stent or a stent-graft |
US5554181A (en) | 1994-05-04 | 1996-09-10 | Regents Of The University Of Minnesota | Stent |
US5824044A (en) | 1994-05-12 | 1998-10-20 | Endovascular Technologies, Inc. | Bifurcated multicapsule intraluminal grafting system |
US5456694A (en) | 1994-05-13 | 1995-10-10 | Stentco, Inc. | Device for delivering and deploying intraluminal devices |
DE4418336A1 (en) | 1994-05-26 | 1995-11-30 | Angiomed Ag | Stent for widening and holding open receptacles |
US5683451A (en) | 1994-06-08 | 1997-11-04 | Cardiovascular Concepts, Inc. | Apparatus and methods for deployment release of intraluminal prostheses |
US5824041A (en) | 1994-06-08 | 1998-10-20 | Medtronic, Inc. | Apparatus and methods for placement and repositioning of intraluminal prostheses |
US6013854A (en) | 1994-06-17 | 2000-01-11 | Terumo Kabushiki Kaisha | Indwelling stent and the method for manufacturing the same |
US5522881A (en) | 1994-06-28 | 1996-06-04 | Meadox Medicals, Inc. | Implantable tubular prosthesis having integral cuffs |
JPH10504738A (en) | 1994-07-08 | 1998-05-12 | マイクロベナ コーポレイション | Medical device forming method and vascular embolization device |
US5397355A (en) | 1994-07-19 | 1995-03-14 | Stentco, Inc. | Intraluminal stent |
US5575816A (en) | 1994-08-12 | 1996-11-19 | Meadox Medicals, Inc. | High strength and high density intraluminal wire stent |
US5571172A (en) | 1994-08-15 | 1996-11-05 | Origin Medsystems, Inc. | Method and apparatus for endoscopic grafting |
US5591230A (en) | 1994-09-07 | 1997-01-07 | Global Therapeutics, Inc. | Radially expandable stent |
US6015429A (en) | 1994-09-08 | 2000-01-18 | Gore Enterprise Holdings, Inc. | Procedures for introducing stents and stent-grafts |
US5653743A (en) | 1994-09-09 | 1997-08-05 | Martin; Eric C. | Hypogastric artery bifurcation graft and method of implantation |
US5765682A (en) | 1994-10-13 | 1998-06-16 | Menlo Care, Inc. | Restrictive package for expandable or shape memory medical devices and method of preventing premature change of same |
CA2175720C (en) | 1996-05-03 | 2011-11-29 | Ian M. Penn | Bifurcated stent and method for the manufacture and delivery of same |
CA2134997C (en) | 1994-11-03 | 2009-06-02 | Ian M. Penn | Stent |
JP3611578B2 (en) | 1994-11-09 | 2005-01-19 | エンドテックス インターベンショナル システムズ,インコーポレイテッド | Delivery catheter and graft for the treatment of aneurysms |
AU3783195A (en) | 1994-11-15 | 1996-05-23 | Advanced Cardiovascular Systems Inc. | Intraluminal stent for attaching a graft |
US5616114A (en) | 1994-12-08 | 1997-04-01 | Neocardia, Llc. | Intravascular radiotherapy employing a liquid-suspended source |
US5630829A (en) | 1994-12-09 | 1997-05-20 | Intervascular, Inc. | High hoop strength intraluminal stent |
US5690671A (en) | 1994-12-13 | 1997-11-25 | Micro Interventional Systems, Inc. | Embolic elements and methods and apparatus for their delivery |
US5879366A (en) | 1996-12-20 | 1999-03-09 | W.L. Gore & Associates, Inc. | Self-expanding defect closure device and method of making and using |
NL9500094A (en) | 1995-01-19 | 1996-09-02 | Industrial Res Bv | Y-shaped stent and method of deployment. |
US5591226A (en) | 1995-01-23 | 1997-01-07 | Schneider (Usa) Inc. | Percutaneous stent-graft and method for delivery thereof |
US5755770A (en) | 1995-01-31 | 1998-05-26 | Boston Scientific Corporatiion | Endovascular aortic graft |
US5575818A (en) | 1995-02-14 | 1996-11-19 | Corvita Corporation | Endovascular stent with locking ring |
US5522883A (en) | 1995-02-17 | 1996-06-04 | Meadox Medicals, Inc. | Endoprosthesis stent/graft deployment system |
CA2213403C (en) | 1995-02-22 | 2007-01-16 | Menlo Care, Inc. | Covered expanding mesh stent |
US5662675A (en) | 1995-02-24 | 1997-09-02 | Intervascular, Inc. | Delivery catheter assembly |
US5683449A (en) | 1995-02-24 | 1997-11-04 | Marcade; Jean Paul | Modular bifurcated intraluminal grafts and methods for delivering and assembling same |
US5681345A (en) | 1995-03-01 | 1997-10-28 | Scimed Life Systems, Inc. | Sleeve carrying stent |
US6818014B2 (en) | 1995-03-01 | 2004-11-16 | Scimed Life Systems, Inc. | Longitudinally flexible expandable stent |
US6124523A (en) | 1995-03-10 | 2000-09-26 | Impra, Inc. | Encapsulated stent |
EP0814729B1 (en) | 1995-03-10 | 2000-08-09 | Impra, Inc. | Endoluminal encapsulated stent and methods of manufacture |
US6039755A (en) | 1997-02-05 | 2000-03-21 | Impra, Inc., A Division Of C.R. Bard, Inc. | Radially expandable tubular polytetrafluoroethylene grafts and method of making same |
WO1996028116A1 (en) | 1995-03-10 | 1996-09-19 | Cardiovascular Concepts, Inc. | Tubular endoluminar prosthesis having oblique ends |
US5591197A (en) | 1995-03-14 | 1997-01-07 | Advanced Cardiovascular Systems, Inc. | Expandable stent forming projecting barbs and method for deploying |
US5647857A (en) | 1995-03-16 | 1997-07-15 | Endotex Interventional Systems, Inc. | Protective intraluminal sheath |
US5666968A (en) | 1995-03-17 | 1997-09-16 | Intelliwire, Inc. | Flexible guide wire with extension capability and guide wire extension for use therewith |
CA2171896C (en) | 1995-03-17 | 2007-05-15 | Scott C. Anderson | Multi-anchor stent |
US5643278A (en) | 1995-04-06 | 1997-07-01 | Leocor, Inc. | Stent delivery system |
EP0740928B1 (en) | 1995-04-12 | 2004-07-07 | Corvita Europe | Self-expanding stent for introducing a medical device in a body cavity and manufacturing process |
AU4632196A (en) | 1995-04-14 | 1996-10-30 | Schneider (Usa) Inc. | Rolling membrane stent delivery device |
US5641373A (en) | 1995-04-17 | 1997-06-24 | Baxter International Inc. | Method of manufacturing a radially-enlargeable PTFE tape-reinforced vascular graft |
US5609628A (en) | 1995-04-20 | 1997-03-11 | Keranen; Victor J. | Intravascular graft and catheter |
ES2129247T3 (en) | 1995-04-21 | 1999-06-01 | Bard Inc C R | SET OF INTERCONNECTABLE CATHETERS. |
US5591198A (en) | 1995-04-27 | 1997-01-07 | Medtronic, Inc. | Multiple sinusoidal wave configuration stent |
FR2733682B1 (en) | 1995-05-04 | 1997-10-31 | Dibie Alain | ENDOPROSTHESIS FOR THE TREATMENT OF STENOSIS ON BIFURCATIONS OF BLOOD VESSELS AND LAYING EQUIPMENT THEREFOR |
US5662614A (en) | 1995-05-09 | 1997-09-02 | Edoga; John K. | Balloon expandable universal access sheath |
US5628786A (en) * | 1995-05-12 | 1997-05-13 | Impra, Inc. | Radially expandable vascular graft with resistance to longitudinal compression and method of making same |
WO1996036297A1 (en) | 1995-05-19 | 1996-11-21 | Kanji Inoue | Transplantation instrument, method of bending same and method of transplanting same |
AU711503B2 (en) | 1995-06-01 | 1999-10-14 | Meadox Medicals, Inc. | Implantable intraluminal prosthesis |
US6151404A (en) | 1995-06-01 | 2000-11-21 | Medical Media Systems | Anatomical visualization system |
AU5950696A (en) | 1995-06-05 | 1996-12-24 | Creative Products Resource, Inc. | Dry-cleaning kit for in-dryer use |
AU5776696A (en) * | 1995-06-08 | 1997-01-09 | Bard Galway Limited | Bifurcated endovascular stent |
RU2157146C2 (en) | 1995-06-13 | 2000-10-10 | ВИЛЬЯМ КУК Европа, A/S | Device for performing implantation in blood vessels and hollow organs |
US5676685A (en) | 1995-06-22 | 1997-10-14 | Razavi; Ali | Temporary stent |
US5989242A (en) | 1995-06-26 | 1999-11-23 | Trimedyne, Inc. | Therapeutic appliance releasing device |
US5766203A (en) | 1995-07-20 | 1998-06-16 | Intelliwire, Inc. | Sheath with expandable distal extremity and balloon catheters and stents for use therewith and method |
GB9518400D0 (en) * | 1995-09-08 | 1995-11-08 | Anson Medical Ltd | A surgical graft/stent system |
US5562697A (en) | 1995-09-18 | 1996-10-08 | William Cook, Europe A/S | Self-expanding stent assembly and methods for the manufacture thereof |
WO1997010757A1 (en) | 1995-09-22 | 1997-03-27 | Autogenics | Sewing ring with integral retaining springs |
US6193745B1 (en) * | 1995-10-03 | 2001-02-27 | Medtronic, Inc. | Modular intraluminal prosteheses construction and methods |
US5824037A (en) | 1995-10-03 | 1998-10-20 | Medtronic, Inc. | Modular intraluminal prostheses construction and methods |
US6099558A (en) | 1995-10-10 | 2000-08-08 | Edwards Lifesciences Corp. | Intraluminal grafting of a bifuricated artery |
WO1997014375A1 (en) | 1995-10-20 | 1997-04-24 | Bandula Wijay | Vascular stent |
US5669924A (en) | 1995-10-26 | 1997-09-23 | Shaknovich; Alexander | Y-shuttle stent assembly for bifurcating vessels and method of using the same |
US5591195A (en) * | 1995-10-30 | 1997-01-07 | Taheri; Syde | Apparatus and method for engrafting a blood vessel |
US6287315B1 (en) | 1995-10-30 | 2001-09-11 | World Medical Manufacturing Corporation | Apparatus for delivering an endoluminal prosthesis |
US6348066B1 (en) * | 1995-11-07 | 2002-02-19 | Corvita Corporation | Modular endoluminal stent-grafts and methods for their use |
US5628788A (en) | 1995-11-07 | 1997-05-13 | Corvita Corporation | Self-expanding endoluminal stent-graft |
ES2131253T3 (en) | 1995-11-14 | 1999-07-16 | Schneider Europ Gmbh | DEVICE FOR THE IMPLEMENTATION OF AN ENDOPROTESIS. |
US5665117A (en) | 1995-11-27 | 1997-09-09 | Rhodes; Valentine J. | Endovascular prosthesis with improved sealing means for aneurysmal arterial disease and method of use |
US5593417A (en) | 1995-11-27 | 1997-01-14 | Rhodes; Valentine J. | Intravascular stent with secure mounting means |
US5824040A (en) | 1995-12-01 | 1998-10-20 | Medtronic, Inc. | Endoluminal prostheses and therapies for highly variable body lumens |
US6576009B2 (en) | 1995-12-01 | 2003-06-10 | Medtronic Ave, Inc. | Bifurcated intraluminal prostheses construction and methods |
EP0866677A4 (en) * | 1995-12-14 | 1999-10-27 | Prograft Medical Inc | Stent-graft deployment apparatus and method |
US6042605A (en) * | 1995-12-14 | 2000-03-28 | Gore Enterprose Holdings, Inc. | Kink resistant stent-graft |
US5693066A (en) | 1995-12-21 | 1997-12-02 | Medtronic, Inc. | Stent mounting and transfer device and method |
US5604435A (en) | 1995-12-29 | 1997-02-18 | General Electric Company | Spiral scanning method for monitoring physiological changes |
DE69732794T2 (en) | 1996-01-05 | 2006-04-06 | Medtronic, Inc., Minneapolis | EXPANDABLE ENDOLUMINARY PROSTHESIS |
US5690642A (en) | 1996-01-18 | 1997-11-25 | Cook Incorporated | Rapid exchange stent delivery balloon catheter |
US5800512A (en) | 1996-01-22 | 1998-09-01 | Meadox Medicals, Inc. | PTFE vascular graft |
AUPN775296A0 (en) | 1996-01-25 | 1996-02-22 | Endogad Research Pty Limited | Directional catheter |
US6017363A (en) | 1997-09-22 | 2000-01-25 | Cordis Corporation | Bifurcated axially flexible stent |
AU723785B2 (en) | 1996-02-02 | 2000-09-07 | Transvascular, Inc. | Methods and apparatus for connecting openings formed in adjacent blood vessels or other anatomical structures |
US5871537A (en) * | 1996-02-13 | 1999-02-16 | Scimed Life Systems, Inc. | Endovascular apparatus |
US5690643A (en) | 1996-02-20 | 1997-11-25 | Leocor, Incorporated | Stent delivery system |
US5695516A (en) | 1996-02-21 | 1997-12-09 | Iso Stent, Inc. | Longitudinally elongating balloon expandable stent |
US5810836A (en) | 1996-03-04 | 1998-09-22 | Myocardial Stents, Inc. | Device and method for trans myocardial revascularization (TMR) |
DE69702316T2 (en) | 1996-03-13 | 2001-02-22 | Medtronic Inc | ENDOLUMINAL PROSTHESES FOR BODY LUME SYSTEMS HAVING MULTIPLE BRANCHES |
US5843160A (en) | 1996-04-01 | 1998-12-01 | Rhodes; Valentine J. | Prostheses for aneurysmal and/or occlusive disease at a bifurcation in a vessel, duct, or lumen |
US5630830A (en) | 1996-04-10 | 1997-05-20 | Medtronic, Inc. | Device and method for mounting stents on delivery systems |
JP3410922B2 (en) | 1996-04-23 | 2003-05-26 | 株式会社東芝 | Clock control circuit |
US6440165B1 (en) * | 1996-05-03 | 2002-08-27 | Medinol, Ltd. | Bifurcated stent with improved side branch aperture and method of making same |
UA58485C2 (en) * | 1996-05-03 | 2003-08-15 | Медінол Лтд. | Method for manufacture of bifurcated stent (variants) and bifurcated stent (variants) |
FR2749160B1 (en) | 1996-05-28 | 1999-05-21 | Patrice Bergeron | MODULAR BIFURCED VASCULAR PROSTHESIS |
US5697971A (en) | 1996-06-11 | 1997-12-16 | Fischell; Robert E. | Multi-cell stent with cells having differing characteristics |
US5928279A (en) | 1996-07-03 | 1999-07-27 | Baxter International Inc. | Stented, radially expandable, tubular PTFE grafts |
GB9614950D0 (en) | 1996-07-16 | 1996-09-04 | Anson Medical Ltd | A ductus stent and delivery catheter |
US6905505B2 (en) | 1996-07-26 | 2005-06-14 | Kensey Nash Corporation | System and method of use for agent delivery and revascularizing of grafts and vessels |
US5980514A (en) | 1996-07-26 | 1999-11-09 | Target Therapeutics, Inc. | Aneurysm closure device assembly |
US5676697A (en) | 1996-07-29 | 1997-10-14 | Cardiovascular Dynamics, Inc. | Two-piece, bifurcated intraluminal graft for repair of aneurysm |
US5823198A (en) | 1996-07-31 | 1998-10-20 | Micro Therapeutics, Inc. | Method and apparatus for intravasculer embolization |
ES2210581T3 (en) | 1996-09-18 | 2004-07-01 | Micro Therapeutics, Inc. | INTRACRANIAL EXTENSIONER. |
US6254628B1 (en) * | 1996-12-09 | 2001-07-03 | Micro Therapeutics, Inc. | Intracranial stent |
US6149681A (en) | 1996-09-20 | 2000-11-21 | Converge Medical, Inc. | Radially expanding prostheses and systems for their deployment |
US6027508A (en) | 1996-10-03 | 2000-02-22 | Scimed Life Systems, Inc. | Stent retrieval device |
EP0944366B1 (en) | 1996-11-04 | 2006-09-13 | Advanced Stent Technologies, Inc. | Extendible double stent |
US6596020B2 (en) | 1996-11-04 | 2003-07-22 | Advanced Stent Technologies, Inc. | Method of delivering a stent with a side opening |
US6692483B2 (en) * | 1996-11-04 | 2004-02-17 | Advanced Stent Technologies, Inc. | Catheter with attached flexible side sheath |
US7220275B2 (en) * | 1996-11-04 | 2007-05-22 | Advanced Stent Technologies, Inc. | Stent with protruding branch portion for bifurcated vessels |
US7341598B2 (en) * | 1999-01-13 | 2008-03-11 | Boston Scientific Scimed, Inc. | Stent with protruding branch portion for bifurcated vessels |
US6325826B1 (en) * | 1998-01-14 | 2001-12-04 | Advanced Stent Technologies, Inc. | Extendible stent apparatus |
US6835203B1 (en) | 1996-11-04 | 2004-12-28 | Advanced Stent Technologies, Inc. | Extendible stent apparatus |
US6395017B1 (en) | 1996-11-15 | 2002-05-28 | C. R. Bard, Inc. | Endoprosthesis delivery catheter with sequential stage control |
CA2271056A1 (en) | 1996-11-15 | 1998-05-22 | Cook Incorporated | Splittable sleeve, stent deployment device |
US5860998A (en) | 1996-11-25 | 1999-01-19 | C. R. Bard, Inc. | Deployment device for tubular expandable prosthesis |
US6352561B1 (en) * | 1996-12-23 | 2002-03-05 | W. L. Gore & Associates | Implant deployment apparatus |
US6551350B1 (en) | 1996-12-23 | 2003-04-22 | Gore Enterprise Holdings, Inc. | Kink resistant bifurcated prosthesis |
US6015431A (en) | 1996-12-23 | 2000-01-18 | Prograft Medical, Inc. | Endolumenal stent-graft with leak-resistant seal |
US5879321A (en) | 1997-01-22 | 1999-03-09 | The University Of Kentucky Research Foundation | Portocaval-right atrial shunt |
ATE275888T1 (en) | 1997-01-29 | 2004-10-15 | Endovascular Tech Inc | MODULAR STENT FABRIC WITH BELL-SHAPED EXTENDED END |
US6203735B1 (en) | 1997-02-03 | 2001-03-20 | Impra, Inc. | Method of making expanded polytetrafluoroethylene products |
US5827321A (en) | 1997-02-07 | 1998-10-27 | Cornerstone Devices, Inc. | Non-Foreshortening intraluminal prosthesis |
US5720735A (en) * | 1997-02-12 | 1998-02-24 | Dorros; Gerald | Bifurcated endovascular catheter |
US5928248A (en) | 1997-02-14 | 1999-07-27 | Biosense, Inc. | Guided deployment of stents |
US6951572B1 (en) | 1997-02-20 | 2005-10-04 | Endologix, Inc. | Bifurcated vascular graft and method and apparatus for deploying same |
US6090128A (en) | 1997-02-20 | 2000-07-18 | Endologix, Inc. | Bifurcated vascular graft deployment device |
US6152944A (en) | 1997-03-05 | 2000-11-28 | Scimed Life Systems, Inc. | Catheter with removable balloon protector and stent delivery system with removable stent protector |
US5893868A (en) | 1997-03-05 | 1999-04-13 | Scimed Life Systems, Inc. | Catheter with removable balloon protector and stent delivery system with removable stent protector |
US5824053A (en) | 1997-03-18 | 1998-10-20 | Endotex Interventional Systems, Inc. | Helical mesh endoprosthesis and methods of use |
US6048360A (en) | 1997-03-18 | 2000-04-11 | Endotex Interventional Systems, Inc. | Methods of making and using coiled sheet graft for single and bifurcated lumens |
US5868783A (en) | 1997-04-16 | 1999-02-09 | Numed, Inc. | Intravascular stent with limited axial shrinkage |
US6143016A (en) | 1997-04-21 | 2000-11-07 | Advanced Cardiovascular Systems, Inc. | Sheath and method of use for a stent delivery system |
US5957929A (en) | 1997-05-02 | 1999-09-28 | Micro Therapeutics, Inc. | Expandable stent apparatus and method |
US5911734A (en) | 1997-05-08 | 1999-06-15 | Embol-X, Inc. | Percutaneous catheter and guidewire having filter and medical device deployment capabilities |
AUPO700897A0 (en) | 1997-05-26 | 1997-06-19 | William A Cook Australia Pty Ltd | A method and means of deploying a graft |
US5906641A (en) | 1997-05-27 | 1999-05-25 | Schneider (Usa) Inc | Bifurcated stent graft |
CA2235911C (en) | 1997-05-27 | 2003-07-29 | Schneider (Usa) Inc. | Stent and stent-graft for treating branched vessels |
CA2238117C (en) | 1997-05-30 | 2006-01-10 | United States Surgical Corporation | Method and instrumentation for implant insertion |
EP0884029B1 (en) | 1997-06-13 | 2004-12-22 | Gary J. Becker | Expandable intraluminal endoprosthesis |
US5855600A (en) * | 1997-08-01 | 1999-01-05 | Inflow Dynamics Inc. | Flexible implantable stent with composite design |
US6070589A (en) | 1997-08-01 | 2000-06-06 | Teramed, Inc. | Methods for deploying bypass graft stents |
US6221090B1 (en) * | 1997-08-13 | 2001-04-24 | Advanced Cardiovascular Systems, Inc. | Stent delivery assembly |
US6361544B1 (en) * | 1997-08-13 | 2002-03-26 | Advanced Cardiovascular Systems, Inc. | Stent and catheter assembly and method for treating bifurcations |
US6165195A (en) * | 1997-08-13 | 2000-12-26 | Advanced Cardiovascylar Systems, Inc. | Stent and catheter assembly and method for treating bifurcations |
US7753950B2 (en) * | 1997-08-13 | 2010-07-13 | Advanced Cardiovascular Systems, Inc. | Stent and catheter assembly and method for treating bifurcations |
US5984929A (en) | 1997-08-29 | 1999-11-16 | Target Therapeutics, Inc. | Fast detaching electronically isolated implant |
US5855599A (en) | 1997-09-02 | 1999-01-05 | Sitek, Inc. | Silicon micro machined occlusion implant |
US6187033B1 (en) * | 1997-09-04 | 2001-02-13 | Meadox Medicals, Inc. | Aortic arch prosthetic graft |
US5984955A (en) | 1997-09-11 | 1999-11-16 | Wisselink; Willem | System and method for endoluminal grafting of bifurcated or branched vessels |
US6592548B2 (en) | 1997-09-18 | 2003-07-15 | Iowa-India Investments Company Limited Of Douglas | Delivery mechanism for balloons, drugs, stents and other physical/mechanical agents and method of use |
US6056722A (en) | 1997-09-18 | 2000-05-02 | Iowa-India Investments Company Limited Of Douglas | Delivery mechanism for balloons, drugs, stents and other physical/mechanical agents and methods of use |
US6520988B1 (en) | 1997-09-24 | 2003-02-18 | Medtronic Ave, Inc. | Endolumenal prosthesis and method of use in bifurcation regions of body lumens |
US6086611A (en) | 1997-09-25 | 2000-07-11 | Ave Connaught | Bifurcated stent |
US5948017A (en) | 1997-10-12 | 1999-09-07 | Taheri; Syde A. | Modular graft assembly |
US5893887A (en) | 1997-10-14 | 1999-04-13 | Iowa-India Investments Company Limited | Stent for positioning at junction of bifurcated blood vessel and method of making |
ES1038606Y (en) | 1997-10-28 | 1999-01-01 | Costilla Garcia Serafin Marcos | FORKED SELF-EXPANDING PROSTHESIS CONVEYOR EQUIPMENT. |
US5961548A (en) | 1997-11-18 | 1999-10-05 | Shmulewitz; Ascher | Bifurcated two-part graft and methods of implantation |
AUPP083597A0 (en) * | 1997-12-10 | 1998-01-08 | William A Cook Australia Pty Ltd | Endoluminal aortic stents |
US6235051B1 (en) * | 1997-12-16 | 2001-05-22 | Timothy P. Murphy | Method of stent-graft system delivery |
US6068654A (en) * | 1997-12-23 | 2000-05-30 | Vascular Science, Inc. | T-shaped medical graft connector |
US6475170B1 (en) | 1997-12-30 | 2002-11-05 | Remon Medical Technologies Ltd | Acoustic biosensor for monitoring physiological conditions in a body implantation site |
US6074398A (en) | 1998-01-13 | 2000-06-13 | Datascope Investment Corp. | Reduced diameter stent/graft deployment catheter |
US7520890B2 (en) | 1998-01-26 | 2009-04-21 | Phillips Peter W | Reinforced graft and method of deployment |
EP1656906A1 (en) | 1998-01-26 | 2006-05-17 | Anson Medical Limited | Reinforced graft |
US6148349A (en) | 1998-02-06 | 2000-11-14 | Ncr Corporation | Dynamic and consistent naming of fabric attached storage by a file system on a compute node storing information mapping API system I/O calls for data objects with a globally unique identification |
US6395018B1 (en) * | 1998-02-09 | 2002-05-28 | Wilfrido R. Castaneda | Endovascular graft and process for bridging a defect in a main vessel near one of more branch vessels |
US6395019B2 (en) | 1998-02-09 | 2002-05-28 | Trivascular, Inc. | Endovascular graft |
US6824550B1 (en) | 2000-04-06 | 2004-11-30 | Norbon Medical, Inc. | Guidewire for crossing occlusions or stenosis |
US6280467B1 (en) | 1998-02-26 | 2001-08-28 | World Medical Manufacturing Corporation | Delivery system for deployment and endovascular assembly of a multi-stage stented graft |
US6077296A (en) | 1998-03-04 | 2000-06-20 | Endologix, Inc. | Endoluminal vascular prosthesis |
US7491232B2 (en) | 1998-09-18 | 2009-02-17 | Aptus Endosystems, Inc. | Catheter-based fastener implantation apparatus and methods with implantation force resolution |
US6129756A (en) | 1998-03-16 | 2000-10-10 | Teramed, Inc. | Biluminal endovascular graft system |
US6224609B1 (en) * | 1998-03-16 | 2001-05-01 | Teramed Inc. | Bifurcated prosthetic graft |
AU3008599A (en) | 1998-03-18 | 1999-10-11 | Meadox Medicals, Inc. | Improved ptfe vascular prosthesis and method of manufacture |
AU746955B2 (en) | 1998-03-27 | 2002-05-09 | Cook Urological Inc. | Minimally-invasive medical retrieval device |
US6063092A (en) | 1998-04-07 | 2000-05-16 | Medtronic Inc. | Heat set and crimping process to optimize stent retention |
US6524336B1 (en) | 1998-04-09 | 2003-02-25 | Cook Incorporated | Endovascular graft |
US6146389A (en) | 1998-04-23 | 2000-11-14 | Boston Scientific Corporation | Stent deployment device and method for deploying a stent |
US6511325B1 (en) * | 1998-05-04 | 2003-01-28 | Advanced Research & Technology Institute | Aortic stent-graft calibration and training model |
US6352554B2 (en) | 1998-05-08 | 2002-03-05 | Sulzer Vascutek Limited | Prosthetic tubular aortic conduit and method for manufacturing the same |
US6093203A (en) | 1998-05-13 | 2000-07-25 | Uflacker; Renan | Stent or graft support structure for treating bifurcated vessels having different diameter portions and methods of use and implantation |
WO1999062431A1 (en) * | 1998-06-02 | 1999-12-09 | Cook Incorporated | Multiple-sided intraluminal medical device |
AU4679499A (en) | 1998-06-10 | 1999-12-30 | Advanced Bypass Technologies, Inc. | Thermal securing anastomosis systems |
US6224627B1 (en) | 1998-06-15 | 2001-05-01 | Gore Enterprise Holdings, Inc. | Remotely removable covering and support |
JP4377546B2 (en) * | 1998-06-19 | 2009-12-02 | エンドロジックス、インク | Self-expanding branch lumen prosthesis |
US6143002A (en) | 1998-08-04 | 2000-11-07 | Scimed Life Systems, Inc. | System for delivering stents to bifurcation lesions |
US6159239A (en) | 1998-08-14 | 2000-12-12 | Prodesco, Inc. | Woven stent/graft structure |
US6296622B1 (en) | 1998-12-21 | 2001-10-02 | Micrus Corporation | Endoluminal device delivery system using axially recovering shape memory material |
US6514281B1 (en) * | 1998-09-04 | 2003-02-04 | Scimed Life Systems, Inc. | System for delivering bifurcation stents |
US6196230B1 (en) | 1998-09-10 | 2001-03-06 | Percardia, Inc. | Stent delivery system and method of use |
US6093194A (en) | 1998-09-14 | 2000-07-25 | Endocare, Inc. | Insertion device for stents and methods for use |
US6096027A (en) | 1998-09-30 | 2000-08-01 | Impra, Inc., A Subsidiary Of C.R. Bard, Inc. | Bag enclosed stent loading apparatus |
US6273909B1 (en) | 1998-10-05 | 2001-08-14 | Teramed Inc. | Endovascular graft system |
US6059813A (en) | 1998-11-06 | 2000-05-09 | Scimed Life Systems, Inc. | Rolling membrane stent delivery system |
US6544278B1 (en) | 1998-11-06 | 2003-04-08 | Scimed Life Systems, Inc. | Rolling membrane stent delivery system |
US6197049B1 (en) * | 1999-02-17 | 2001-03-06 | Endologix, Inc. | Articulating bifurcation graft |
US6660030B2 (en) | 1998-12-11 | 2003-12-09 | Endologix, Inc. | Bifurcation graft deployment catheter |
US6187036B1 (en) * | 1998-12-11 | 2001-02-13 | Endologix, Inc. | Endoluminal vascular prosthesis |
US6733523B2 (en) | 1998-12-11 | 2004-05-11 | Endologix, Inc. | Implantable vascular graft |
JP4189127B2 (en) | 1998-12-11 | 2008-12-03 | エンドロジックス、インク | Intraluminal artificial blood vessels |
US6059824A (en) * | 1998-12-23 | 2000-05-09 | Taheri; Syde A. | Mated main and collateral stent and method for treatment of arterial disease |
US6254609B1 (en) | 1999-01-11 | 2001-07-03 | Scimed Life Systems, Inc. | Self-expanding stent delivery system with two sheaths |
US6193726B1 (en) | 1999-01-15 | 2001-02-27 | Heartstent Corporation | Insertion tool for transmyocardial implant |
EP1600124B1 (en) | 1999-01-22 | 2008-01-02 | Gore Enterprise Holdings, Inc. | Method for compacting an endoprosthesis |
WO2000044309A2 (en) | 1999-02-01 | 2000-08-03 | Board Of Regents, The University Of Texas System | Woven bifurcated and trifurcated stents and methods for making the same |
US6361557B1 (en) * | 1999-02-05 | 2002-03-26 | Medtronic Ave, Inc. | Staplebutton radiopaque marker |
US6261316B1 (en) | 1999-03-11 | 2001-07-17 | Endologix, Inc. | Single puncture bifurcation graft deployment system |
US8034100B2 (en) | 1999-03-11 | 2011-10-11 | Endologix, Inc. | Graft deployment system |
NL1011779C2 (en) | 1999-04-13 | 2000-10-16 | Elephant Dental Bv | Biomedical device or implant. |
US6425765B1 (en) | 1999-04-14 | 2002-07-30 | Irwin, Iii Albert J. | Training device for archers |
US6162237A (en) | 1999-04-19 | 2000-12-19 | Chan; Winston Kam Yew | Temporary intravascular stent for use in retrohepatic IVC or hepatic vein injury |
EP1095635A4 (en) * | 1999-05-06 | 2007-06-20 | Kanji Inoue | Apparatus for folding instrument and use of the same apparatus |
US6146415A (en) | 1999-05-07 | 2000-11-14 | Advanced Cardiovascular Systems, Inc. | Stent delivery system |
US6290673B1 (en) * | 1999-05-20 | 2001-09-18 | Conor Medsystems, Inc. | Expandable medical device delivery system and method |
US7387639B2 (en) | 1999-06-04 | 2008-06-17 | Advanced Stent Technologies, Inc. | Short sleeve stent delivery catheter and methods |
US6287329B1 (en) | 1999-06-28 | 2001-09-11 | Nitinol Development Corporation | Stent keeper for a self-expanding stent delivery system |
US6440161B1 (en) | 1999-07-07 | 2002-08-27 | Endologix, Inc. | Dual wire placement catheter |
US6565597B1 (en) * | 1999-07-16 | 2003-05-20 | Med Institute, Inc. | Stent adapted for tangle-free deployment |
ATE492251T1 (en) | 1999-08-23 | 2011-01-15 | Conceptus Inc | TUBAL CONTRACEPTIVE DELIVERY AND DEPLOYMENT CATHETER SYSTEM |
US6409757B1 (en) | 1999-09-15 | 2002-06-25 | Eva Corporation | Method and apparatus for supporting a graft assembly |
US6183481B1 (en) | 1999-09-22 | 2001-02-06 | Endomed Inc. | Delivery system for self-expanding stents and grafts |
US6344056B1 (en) * | 1999-12-29 | 2002-02-05 | Edwards Lifesciences Corp. | Vascular grafts for bridging a vessel side branch |
WO2001024732A1 (en) | 1999-10-04 | 2001-04-12 | Kanji Inoue | Method of folding transplanting instrument and transplanting instrument |
US20020198585A1 (en) | 1999-10-05 | 2002-12-26 | Willem Wisselink | System and method for edoluminal grafting of bifurcated or branched vessels |
US6383213B2 (en) * | 1999-10-05 | 2002-05-07 | Advanced Cardiovascular Systems, Inc. | Stent and catheter assembly and method for treating bifurcations |
ATE301426T1 (en) | 1999-10-08 | 2005-08-15 | Gen Hospital Corp | PERCUTANE STENT PROSTHESIS |
EP1225935A4 (en) | 1999-10-12 | 2009-07-29 | Allan R Will | Methods and devices for protecting a passageway in a body |
US7074235B1 (en) | 1999-10-16 | 2006-07-11 | Sumit Roy | Low-profile, non-stented prosthesis for transluminal implantation |
US6402764B1 (en) | 1999-11-15 | 2002-06-11 | Cardica, Inc. | Everter and threadthrough system for attaching graft vessel to anastomosis device |
US6585758B1 (en) | 1999-11-16 | 2003-07-01 | Scimed Life Systems, Inc. | Multi-section filamentary endoluminal stent |
AU1723201A (en) | 1999-11-18 | 2001-05-30 | Petrus Besselink | Method for placing bifurcated stents |
US6652567B1 (en) | 1999-11-18 | 2003-11-25 | David H. Deaton | Fenestrated endovascular graft |
US6280466B1 (en) * | 1999-12-03 | 2001-08-28 | Teramed Inc. | Endovascular graft system |
US6387120B2 (en) * | 1999-12-09 | 2002-05-14 | Advanced Cardiovascular Systems, Inc. | Stent and catheter assembly and method for treating bifurcations |
US6331184B1 (en) | 1999-12-10 | 2001-12-18 | Scimed Life Systems, Inc. | Detachable covering for an implantable medical device |
US6361555B1 (en) * | 1999-12-15 | 2002-03-26 | Advanced Cardiovascular Systems, Inc. | Stent and stent delivery assembly and method of use |
US6280465B1 (en) | 1999-12-30 | 2001-08-28 | Advanced Cardiovascular Systems, Inc. | Apparatus and method for delivering a self-expanding stent on a guide wire |
US6334866B1 (en) | 2000-01-14 | 2002-01-01 | William H. Wall | Stent device for performing endovascular repair of aneurysms |
US6622604B1 (en) | 2000-01-31 | 2003-09-23 | Scimed Life Systems, Inc. | Process for manufacturing a braided bifurcated stent |
US6398807B1 (en) | 2000-01-31 | 2002-06-04 | Scimed Life Systems, Inc. | Braided branching stent, method for treating a lumen therewith, and process for manufacture therefor |
US6814752B1 (en) | 2000-03-03 | 2004-11-09 | Endovascular Technologies, Inc. | Modular grafting system and method |
CA2397980C (en) | 2000-03-03 | 2009-08-04 | Cook Incorporated | Endovascular device having a stent |
US6416474B1 (en) | 2000-03-10 | 2002-07-09 | Ramon Medical Technologies Ltd. | Systems and methods for deploying a biosensor in conjunction with a prosthesis |
WO2001067993A2 (en) | 2000-03-14 | 2001-09-20 | Cook Incorporated | Endovascular stent graft |
US7201770B2 (en) | 2000-03-21 | 2007-04-10 | Cordis Corporation | Everting balloon stent delivery system having tapered leading edge |
US6468301B1 (en) | 2000-03-27 | 2002-10-22 | Aga Medical Corporation | Repositionable and recapturable vascular stent/graft |
DE10017147C2 (en) | 2000-04-03 | 2003-06-12 | Wolfram Voelker | Washable guidewire for a catheter |
US6517573B1 (en) * | 2000-04-11 | 2003-02-11 | Endovascular Technologies, Inc. | Hook for attaching to a corporeal lumen and method of manufacturing |
US6702843B1 (en) | 2000-04-12 | 2004-03-09 | Scimed Life Systems, Inc. | Stent delivery means with balloon retraction means |
US6432130B1 (en) | 2000-04-20 | 2002-08-13 | Scimed Life Systems, Inc. | Fully sheathed balloon expandable stent delivery system |
US6942691B1 (en) | 2000-04-27 | 2005-09-13 | Timothy A. M. Chuter | Modular bifurcated graft for endovascular aneurysm repair |
US7241300B2 (en) | 2000-04-29 | 2007-07-10 | Medtronic, Inc, | Components, systems and methods for forming anastomoses using magnetism or other coupling means |
US7232449B2 (en) | 2000-04-29 | 2007-06-19 | Medtronic, Inc. | Components, systems and methods for forming anastomoses using magnetism or other coupling means |
US7666221B2 (en) | 2000-05-01 | 2010-02-23 | Endovascular Technologies, Inc. | Lock modular graft component junctions |
US6592612B1 (en) | 2000-05-04 | 2003-07-15 | Cardeon Corporation | Method and apparatus for providing heat exchange within a catheter body |
US6652579B1 (en) | 2000-06-22 | 2003-11-25 | Advanced Cardiovascular Systems, Inc. | Radiopaque stent |
SE522805C2 (en) | 2000-06-22 | 2004-03-09 | Jan Otto Solem | Stent Application System |
US6482211B1 (en) | 2000-07-31 | 2002-11-19 | Advanced Cardiovascular Systems, Inc. | Angulated stent delivery system and method of use |
US6475166B1 (en) | 2000-08-18 | 2002-11-05 | Endovascular Technologies, Inc. | Guidewire placement system for delivery of an aneurysm graft limb |
ES2257436T3 (en) | 2000-08-23 | 2006-08-01 | Thoratec Corporation | VASCULATOR IMPLANTS COVERED AND USE PROCEDURES. |
NO312223B1 (en) * | 2000-09-05 | 2002-04-15 | Leiv Eiriksson Nyfotek As | Coated expandable stent |
US6607552B1 (en) | 2000-09-18 | 2003-08-19 | Scimed Life Systems, Inc. | Rolling socks |
WO2002030329A2 (en) | 2000-10-13 | 2002-04-18 | Rex Medical, L.P. | Covered stents with side branch |
US6582394B1 (en) | 2000-11-14 | 2003-06-24 | Advanced Cardiovascular Systems, Inc. | Stent and catheter assembly and method for treating bifurcated vessels |
US6942692B2 (en) | 2000-11-16 | 2005-09-13 | Cordis Corporation | Supra-renal prosthesis and renal artery bypass |
US7229472B2 (en) | 2000-11-16 | 2007-06-12 | Cordis Corporation | Thoracic aneurysm repair prosthesis and system |
US7314483B2 (en) * | 2000-11-16 | 2008-01-01 | Cordis Corp. | Stent graft with branch leg |
US7267685B2 (en) | 2000-11-16 | 2007-09-11 | Cordis Corporation | Bilateral extension prosthesis and method of delivery |
US20040106972A1 (en) | 2000-11-20 | 2004-06-03 | Deaton David H. | Fenestrated endovascular graft |
US6582460B1 (en) | 2000-11-20 | 2003-06-24 | Advanced Cardiovascular Systems, Inc. | System and method for accurately deploying a stent |
US6579308B1 (en) | 2000-11-28 | 2003-06-17 | Scimed Life Systems, Inc. | Stent devices with detachable distal or proximal wires |
US6645242B1 (en) | 2000-12-11 | 2003-11-11 | Stephen F. Quinn | Bifurcated side-access intravascular stent graft |
IL140870A0 (en) | 2001-01-11 | 2002-02-10 | Mind Guard Ltd | Deployment system for implantable self-expandable intraluminal devices |
ATE387167T1 (en) | 2001-01-19 | 2008-03-15 | Boston Scient Ltd | DEVICE FOR INSERTING A BRANCH PROSTHESIS |
US6899727B2 (en) | 2001-01-22 | 2005-05-31 | Gore Enterprise Holdings, Inc. | Deployment system for intraluminal devices |
US6840950B2 (en) | 2001-02-20 | 2005-01-11 | Scimed Life Systems, Inc. | Low profile emboli capture device |
WO2002067653A2 (en) | 2001-02-26 | 2002-09-06 | Scimed Life Systems, Inc. | Bifurcated stent and delivery system |
US20020123786A1 (en) | 2001-03-02 | 2002-09-05 | Ventrica, Inc. | Methods and devices for bypassing an obstructed target vessel by placing the vessel in communication with a heart chamber containing blood |
US6918925B2 (en) | 2001-03-23 | 2005-07-19 | Hassan Tehrani | Branched aortic arch stent graft and method of deployment |
DE60104647T2 (en) | 2001-03-27 | 2005-08-11 | William Cook Europe Aps | Vascular graft for the aorta |
KR20030094304A (en) | 2001-03-28 | 2003-12-11 | 쿡 인코포레이티드 | Modular stent graft assembly and use thereof |
US6761733B2 (en) | 2001-04-11 | 2004-07-13 | Trivascular, Inc. | Delivery system and method for bifurcated endovascular graft |
US20040073288A1 (en) * | 2001-07-06 | 2004-04-15 | Andrew Kerr | Stent/graft assembly |
US7175651B2 (en) | 2001-07-06 | 2007-02-13 | Andrew Kerr | Stent/graft assembly |
US7105017B2 (en) | 2001-04-11 | 2006-09-12 | Andrew Kerr | Axially-connected stent/graft assembly |
US20040138734A1 (en) | 2001-04-11 | 2004-07-15 | Trivascular, Inc. | Delivery system and method for bifurcated graft |
US7201940B1 (en) | 2001-06-12 | 2007-04-10 | Advanced Cardiovascular Systems, Inc. | Method and apparatus for thermal spray processing of medical devices |
JP2004529735A (en) | 2001-06-18 | 2004-09-30 | イーバ コーポレイション | Prosthetic implants and their use |
US6994722B2 (en) | 2001-07-03 | 2006-02-07 | Scimed Life Systems, Inc. | Implant having improved fixation to a body lumen and method for implanting the same |
US6887251B1 (en) | 2001-07-12 | 2005-05-03 | William D. Suval | Method and apparatus for vessel harvesting |
US6767359B2 (en) | 2001-09-28 | 2004-07-27 | Ethicon, Inc. | Prosthesis for the repair of thoracic or abdominal aortic aneurysms and method therefor |
US6981977B2 (en) * | 2001-10-26 | 2006-01-03 | Atrium Medical Corporation | Body fluid cartridge exchange platform device |
AUPR847301A0 (en) | 2001-10-26 | 2001-11-15 | Cook Incorporated | Endoluminal prostheses for curved lumens |
US7029496B2 (en) * | 2001-11-07 | 2006-04-18 | Scimed Life Systems, Inc. | Interlocking endoluminal device |
US7828838B2 (en) | 2001-11-28 | 2010-11-09 | Aptus Endosystems, Inc. | Devices, systems, and methods for prosthesis delivery and implantation, including a prosthesis assembly |
JP4405262B2 (en) | 2001-11-28 | 2010-01-27 | アプタス エンドシステムズ, インコーポレイテッド | Intravascular aneurysm repair system |
US6929661B2 (en) | 2001-11-28 | 2005-08-16 | Aptus Endosystems, Inc. | Multi-lumen prosthesis systems and methods |
US20030176914A1 (en) | 2003-01-21 | 2003-09-18 | Rabkin Dmitry J. | Multi-segment modular stent and methods for manufacturing stents |
US7014653B2 (en) * | 2001-12-20 | 2006-03-21 | Cleveland Clinic Foundation | Furcated endovascular prosthesis |
US7125464B2 (en) | 2001-12-20 | 2006-10-24 | Boston Scientific Santa Rosa Corp. | Method for manufacturing an endovascular graft section |
US6723116B2 (en) * | 2002-01-14 | 2004-04-20 | Syde A. Taheri | Exclusion of ascending/descending aorta and/or aortic arch aneurysm |
US6939368B2 (en) | 2002-01-17 | 2005-09-06 | Scimed Life Systems, Inc. | Delivery system for self expanding stents for use in bifurcated vessels |
US7162302B2 (en) | 2002-03-04 | 2007-01-09 | Nanoset Llc | Magnetically shielded assembly |
ATE425720T1 (en) * | 2002-01-28 | 2009-04-15 | Orbusneich Medical Inc | EXPANDED OSTIUM ENDPROSTHESIS AND DELIVERY SYSTEM |
US7785340B2 (en) | 2002-02-04 | 2010-08-31 | Boston Scientific Scimed, Inc. | Bonding sleeve for medical device |
US6790224B2 (en) | 2002-02-04 | 2004-09-14 | Scimed Life Systems, Inc. | Medical devices |
US7029494B2 (en) | 2002-02-08 | 2006-04-18 | Scimed Life Systems, Inc. | Braided modular stent with hourglass-shaped interfaces |
US7004964B2 (en) | 2002-02-22 | 2006-02-28 | Scimed Life Systems, Inc. | Apparatus and method for deployment of an endoluminal device |
US7235095B2 (en) | 2002-02-22 | 2007-06-26 | Scimed Life Systems, Inc. | Method and system for deploying multi-part endoluminal devices |
US7708771B2 (en) | 2002-02-26 | 2010-05-04 | Endovascular Technologies, Inc. | Endovascular graft device and methods for attaching components thereof |
US6989024B2 (en) | 2002-02-28 | 2006-01-24 | Counter Clockwise, Inc. | Guidewire loaded stent for delivery through a catheter |
US6800065B2 (en) | 2002-04-04 | 2004-10-05 | Medtronic Ave, Inc. | Catheter and guide wire exchange system |
US7131991B2 (en) | 2002-04-24 | 2006-11-07 | Medtronic Vascular, Inc. | Endoluminal prosthetic assembly and extension method |
US7550002B2 (en) | 2002-04-30 | 2009-06-23 | Olympus Corporation | Stent delivery device |
US7122048B2 (en) | 2002-05-03 | 2006-10-17 | Scimed Life Systems, Inc. | Hypotube endoluminal device |
US7270675B2 (en) | 2002-05-10 | 2007-09-18 | Cordis Corporation | Method of forming a tubular membrane on a structural frame |
US7485141B2 (en) | 2002-05-10 | 2009-02-03 | Cordis Corporation | Method of placing a tubular membrane on a structural frame |
US7189256B2 (en) | 2002-05-10 | 2007-03-13 | Scimed Life Systems, Inc. | Endoluminal device and system and method for detecting a change in pressure differential across an endoluminal device |
US6827706B2 (en) | 2002-05-14 | 2004-12-07 | Dennis R. Tollini | Winged catheter securing tape |
US7195648B2 (en) | 2002-05-16 | 2007-03-27 | Cordis Neurovascular, Inc. | Intravascular stent device |
DE10223232B4 (en) | 2002-05-24 | 2004-06-03 | OCé PRINTING SYSTEMS GMBH | Method and device for conveying toner material from a storage container and the associated toner storage container |
US7314481B2 (en) | 2002-05-31 | 2008-01-01 | Wilson-Cook Medical Inc. | Stent introducer apparatus |
US7261733B1 (en) | 2002-06-07 | 2007-08-28 | Endovascular Technologies, Inc. | Endovascular graft with sensors design and attachment methods |
US7264632B2 (en) | 2002-06-07 | 2007-09-04 | Medtronic Vascular, Inc. | Controlled deployment delivery system |
US6858038B2 (en) | 2002-06-21 | 2005-02-22 | Richard R. Heuser | Stent system |
US20030236565A1 (en) | 2002-06-21 | 2003-12-25 | Dimatteo Kristian | Implantable prosthesis |
US6833003B2 (en) | 2002-06-24 | 2004-12-21 | Cordis Neurovascular | Expandable stent and delivery system |
US7232459B2 (en) | 2002-06-28 | 2007-06-19 | Cook Incorporated | Thoracic aortic aneurysm stent graft |
US7122051B1 (en) | 2002-07-12 | 2006-10-17 | Endovascular Technologies, Inc. | Universal length sizing and dock for modular bifurcated endovascular graft |
US6802859B1 (en) | 2002-07-12 | 2004-10-12 | Endovascular Technologies, Inc. | Endovascular stent-graft with flexible bifurcation |
US20050033405A1 (en) * | 2002-08-15 | 2005-02-10 | Gmp/Cardiac Care, Inc. | Rail stent-graft for repairing abdominal aortic aneurysm |
WO2004017866A1 (en) | 2002-08-20 | 2004-03-04 | Cook Incorporated | Stent graft with improved proximal end |
AU2003258337A1 (en) | 2002-08-23 | 2004-03-11 | Cook Incorporated | Asymmetric stent graft attachment |
AU2002951147A0 (en) | 2002-09-02 | 2002-09-19 | Cook Incorporated | Branch grafting device and method |
US7264631B2 (en) | 2002-09-16 | 2007-09-04 | Scimed Life Systems, Inc. | Devices and methods for AAA management |
US7001422B2 (en) | 2002-09-23 | 2006-02-21 | Cordis Neurovascular, Inc | Expandable stent and delivery system |
US6994721B2 (en) | 2002-10-21 | 2006-02-07 | Israel Henry M | Stent assembly |
US20040098096A1 (en) | 2002-10-22 | 2004-05-20 | The University Of Miami | Endograft device to inhibit endoleak and migration |
US7144422B1 (en) | 2002-11-13 | 2006-12-05 | Advanced Cardiovascular Systems, Inc. | Drug-eluting stent and methods of making the same |
US7527636B2 (en) | 2002-11-14 | 2009-05-05 | Medtronic Vascular, Inc | Intraluminal guidewire with hydraulically collapsible self-expanding protection device |
US6923829B2 (en) | 2002-11-25 | 2005-08-02 | Advanced Bio Prosthetic Surfaces, Ltd. | Implantable expandable medical devices having regions of differential mechanical properties and methods of making same |
JP2006507872A (en) | 2002-11-26 | 2006-03-09 | エンドロジックス、インク. | Graft deployment system |
EP1567093B1 (en) | 2002-12-04 | 2009-01-21 | Cook Incorporated | Method and device for treating aortic dissection |
US6948017B2 (en) | 2002-12-18 | 2005-09-20 | International Business Machines Corporation | Method and apparatus having dynamically scalable clock domains for selectively interconnecting subsystems on a synchronous bus |
US7300460B2 (en) | 2002-12-31 | 2007-11-27 | Counter Clockwise, Inc. | Bifurcated guidewire and methods of use |
US6849084B2 (en) | 2002-12-31 | 2005-02-01 | Intek Technology L.L.C. | Stent delivery system |
CA2512610C (en) | 2003-01-14 | 2008-12-23 | The Cleveland Clinic Foundation | Branched vessel endoluminal device |
US7407509B2 (en) | 2003-01-14 | 2008-08-05 | The Cleveland Clinic Foundation | Branched vessel endoluminal device with fenestration |
US9125733B2 (en) * | 2003-01-14 | 2015-09-08 | The Cleveland Clinic Foundation | Branched vessel endoluminal device |
US7004926B2 (en) | 2003-02-25 | 2006-02-28 | Cleveland Clinic Foundation | Apparatus and method for auto-retroperfusion of a coronary vein |
US7182735B2 (en) * | 2003-02-26 | 2007-02-27 | Scimed Life Systems, Inc. | Elongated intracorporal medical device |
US7025779B2 (en) | 2003-02-26 | 2006-04-11 | Scimed Life Systems, Inc. | Endoluminal device having enhanced affixation characteristics |
WO2004080352A1 (en) | 2003-03-12 | 2004-09-23 | Cook Incorporated | Prosthetic valve that permits retrograde flow |
US7220274B1 (en) | 2003-03-21 | 2007-05-22 | Quinn Stephen F | Intravascular stent grafts and methods for deploying the same |
US20050049672A1 (en) | 2003-03-24 | 2005-03-03 | Murphy Kieran P. | Stent delivery system and method using a balloon for a self-expandable stent |
ES2346059T3 (en) | 2003-03-26 | 2010-10-08 | Biosensors International Group Ltd. | IMPLANT SUPPLY CATHETER WITH ELECTROLYTICALLY EROSIONABLE JOINTS. |
US6984244B2 (en) | 2003-03-27 | 2006-01-10 | Endovascular Technologies, Inc. | Delivery system for endoluminal implant |
WO2004089249A1 (en) | 2003-04-03 | 2004-10-21 | William A. Cook Australia Pty. Ltd. | Branch stent graft deployment and method |
US7972372B2 (en) | 2003-04-14 | 2011-07-05 | Tryton Medical, Inc. | Kit for treating vascular bifurcations |
US8109987B2 (en) | 2003-04-14 | 2012-02-07 | Tryton Medical, Inc. | Method of treating a lumenal bifurcation |
US7591832B2 (en) | 2003-04-24 | 2009-09-22 | Medtronic, Inc. | Expandable guide sheath and apparatus with distal protection and methods for use |
US7438721B2 (en) | 2003-04-25 | 2008-10-21 | Medtronic Vascular, Inc. | Universal modular stent graft assembly to accommodate flow to collateral branches |
EP1635736A2 (en) | 2003-06-05 | 2006-03-22 | FlowMedica, Inc. | Systems and methods for performing bi-lateral interventions or diagnosis in branched body lumens |
US7105015B2 (en) | 2003-06-17 | 2006-09-12 | Medtronic Vascular, Inc. | Method and system for treating an ostium of a side-branch vessel |
WO2005013855A2 (en) | 2003-08-01 | 2005-02-17 | Cook Urological, Incorporated | Implant delivery device |
US8784472B2 (en) | 2003-08-15 | 2014-07-22 | Boston Scientific Scimed, Inc. | Clutch driven stent delivery system |
US20050060025A1 (en) | 2003-09-12 | 2005-03-17 | Mackiewicz David A. | Radiopaque markers for medical devices |
US7651519B2 (en) | 2003-09-16 | 2010-01-26 | Cook Incorporated | Prosthesis deployment system |
US20050059994A1 (en) | 2003-09-17 | 2005-03-17 | Steven Walak | Fatigue resistant medical devices |
US20050059923A1 (en) * | 2003-09-17 | 2005-03-17 | Ricardo Gamboa | Fenestration with intrinsic means of selective closure incorporated to a tubular body and used in interventional cardiovascular procedures |
US7559948B2 (en) * | 2003-09-17 | 2009-07-14 | Ricardo Gamboa | Fenestrated asymmetric intracardiac device for the completion of total cavopulmonary anastomosis through cardiac catheterization |
US7122052B2 (en) | 2003-09-29 | 2006-10-17 | Stout Medical Group Lp | Integral support stent graft assembly |
US20050113693A1 (en) | 2003-10-03 | 2005-05-26 | Smith Stephen W. | Kits including 3-D ultrasound imaging catheters, connectable deployable tools, and deployment devices for use in deployment of such tools |
US7967829B2 (en) | 2003-10-09 | 2011-06-28 | Boston Scientific Scimed, Inc. | Medical device delivery system |
EP1682042B1 (en) | 2003-10-10 | 2015-09-02 | Cook Medical Technologies LLC | Composite stent graft |
AU2004279458B2 (en) | 2003-10-10 | 2009-12-10 | Cook Incorporated | Fenestrated stent grafts |
EP1673037B1 (en) | 2003-10-10 | 2009-08-26 | The Cleveland Clinic Foundation | Endoluminal prosthesis with interconnectable modules |
AU2004279459B2 (en) | 2003-10-10 | 2010-12-02 | Cook Incorporated | Stent graft fenestration |
WO2005037133A2 (en) | 2003-10-10 | 2005-04-28 | Arshad Quadri | System and method for endoluminal grafting of bifurcated and branched vessels |
EP3031425B1 (en) | 2003-10-14 | 2022-03-30 | Cook Medical Technologies LLC | Introducer for an iliac side branch device |
US7553324B2 (en) | 2003-10-14 | 2009-06-30 | Xtent, Inc. | Fixed stent delivery devices and methods |
AU2004281122B2 (en) | 2003-10-15 | 2010-04-15 | Kabushikikaisha Igaki Iryo Sekkei | Vessel stent feeder |
US7641684B2 (en) | 2003-10-16 | 2010-01-05 | Minvasys, Sa | Catheter system for stenting bifurcated vessels |
US7695508B2 (en) | 2003-10-16 | 2010-04-13 | Minvasys Sa | Catheter system for stenting bifurcated vessels |
US7144421B2 (en) | 2003-11-06 | 2006-12-05 | Carpenter Judith T | Endovascular prosthesis, system and method |
US9078780B2 (en) * | 2003-11-08 | 2015-07-14 | Cook Medical Technologies Llc | Balloon flareable branch vessel prosthesis and method |
US20050131526A1 (en) | 2003-12-10 | 2005-06-16 | Shing-Chiu Wong | Stent and balloon system for bifurcated vessels and lesions |
EP1706069B1 (en) | 2004-01-20 | 2009-07-01 | Cook Incorporated | Endoluminal stent-graft with sutured attachment |
US7632299B2 (en) | 2004-01-22 | 2009-12-15 | Boston Scientific Scimed, Inc. | Medical devices |
US20050240153A1 (en) | 2004-01-23 | 2005-10-27 | Opie John C | Vascular sheath |
US20050165480A1 (en) | 2004-01-23 | 2005-07-28 | Maybelle Jordan | Endovascular treatment devices and methods |
US7572289B2 (en) | 2004-01-27 | 2009-08-11 | Med Institute, Inc. | Anchoring barb for attachment to a medical prosthesis |
US20050177221A1 (en) | 2004-02-06 | 2005-08-11 | Mustapha Jihad A. | Ostial stent |
US7294145B2 (en) | 2004-02-26 | 2007-11-13 | Boston Scientific Scimed, Inc. | Stent with differently coated inside and outside surfaces |
US20060142838A1 (en) | 2004-12-29 | 2006-06-29 | Masoud Molaei | Medical devices including metallic films and methods for loading and deploying same |
US7753951B2 (en) * | 2004-03-04 | 2010-07-13 | Y Med, Inc. | Vessel treatment devices |
US8007528B2 (en) | 2004-03-17 | 2011-08-30 | Boston Scientific Scimed, Inc. | Bifurcated stent |
US7402106B2 (en) | 2004-03-24 | 2008-07-22 | Bay Tek Games, Inc. | Computer controlled car racing game |
US20050216043A1 (en) | 2004-03-26 | 2005-09-29 | Blatter Duane D | Stented end graft vessel device for anastomosis and related methods for percutaneous placement |
US7244444B2 (en) | 2004-03-31 | 2007-07-17 | Cook Incorporated | Graft material, stent graft and method |
US7674284B2 (en) | 2004-03-31 | 2010-03-09 | Cook Incorporated | Endoluminal graft |
US20050273150A1 (en) | 2004-03-31 | 2005-12-08 | Howell Douglas D | Stent introducer system |
US8377110B2 (en) | 2004-04-08 | 2013-02-19 | Endologix, Inc. | Endolumenal vascular prosthesis with neointima inhibiting polymeric sleeve |
US9770320B2 (en) | 2004-04-12 | 2017-09-26 | Cook Medical Technologies Llc | Stent graft repair device |
US7758633B2 (en) | 2004-04-12 | 2010-07-20 | Boston Scientific Scimed, Inc. | Varied diameter vascular graft |
US7909873B2 (en) | 2006-12-15 | 2011-03-22 | Soteira, Inc. | Delivery apparatus and methods for vertebrostenting |
US7285130B2 (en) | 2004-04-27 | 2007-10-23 | Boston Scientific Scimed, Inc. | Stent delivery system |
EP1753369B1 (en) * | 2004-06-08 | 2013-05-29 | Advanced Stent Technologies, Inc. | Stent with protruding branch portion for bifurcated vessels |
EP1765222B1 (en) | 2004-06-15 | 2012-10-31 | Cook Medical Technologies LLC | Stent graft with internal tube |
EP1621161B1 (en) | 2004-07-28 | 2009-11-18 | Cordis Corporation | Device having connected bifurcated legs to treat abdominal aortic aneurysm |
ATE389370T1 (en) | 2004-09-02 | 2008-04-15 | Med Inst Inc | MODULAR PROSTHESIS AND METHODS FOR BRANCH VESSELS |
US8226706B2 (en) * | 2004-09-22 | 2012-07-24 | Cook Medical Technologies Llc | Stent graft with integral side arm |
US7635383B2 (en) * | 2004-09-28 | 2009-12-22 | Boston Scientific Scimed, Inc. | Rotating stent delivery system for side branch access and protection and method of using same |
US20060089704A1 (en) * | 2004-10-25 | 2006-04-27 | Myles Douglas | Vascular graft and deployment system |
US7699883B2 (en) | 2004-10-25 | 2010-04-20 | Myles Douglas | Vascular graft and deployment system |
US7347868B2 (en) | 2004-10-26 | 2008-03-25 | Baronova, Inc. | Medical device delivery catheter |
WO2006072835A2 (en) | 2004-11-03 | 2006-07-13 | Jacques Seguin | Vascular graft and deployment system |
WO2006065926A1 (en) | 2004-12-15 | 2006-06-22 | Cook Incorporated | Multifilar cable catheter |
EP1846078A4 (en) | 2004-12-16 | 2009-12-23 | Carlos Ruiz | Separable sheath and method of using |
US20070150051A1 (en) | 2005-01-10 | 2007-06-28 | Duke Fiduciary, Llc | Vascular implants and methods of fabricating the same |
US20060155366A1 (en) | 2005-01-10 | 2006-07-13 | Laduca Robert | Apparatus and method for deploying an implantable device within the body |
US8128680B2 (en) | 2005-01-10 | 2012-03-06 | Taheri Laduca Llc | Apparatus and method for deploying an implantable device within the body |
US7306623B2 (en) | 2005-01-13 | 2007-12-11 | Medtronic Vascular, Inc. | Branch vessel graft design and deployment method |
WO2006079006A2 (en) | 2005-01-21 | 2006-07-27 | Gen 4, Llc | Modular stent graft employing bifurcated graft and leg locking stent elements |
TW200635566A (en) | 2005-01-25 | 2006-10-16 | Vnus Med Tech Inc | Structures for permanent occlusion of a hollow anatomical structure |
US20060173525A1 (en) | 2005-02-02 | 2006-08-03 | Percutaneous Systems, Inc. | Methods and systems for deploying luminal prostheses |
US7828837B2 (en) | 2005-02-17 | 2010-11-09 | Khoury Medical Devices, LLC. | Vascular endograft |
US20060224232A1 (en) | 2005-04-01 | 2006-10-05 | Trivascular, Inc. | Hybrid modular endovascular graft |
US7402168B2 (en) | 2005-04-11 | 2008-07-22 | Xtent, Inc. | Custom-length stent delivery system with independently operable expansion elements |
US20060229699A1 (en) | 2005-04-12 | 2006-10-12 | Tehrani Nasser S | Stent-stabilizing device |
US20060233991A1 (en) | 2005-04-13 | 2006-10-19 | Trivascular, Inc. | PTFE layers and methods of manufacturing |
US20060233990A1 (en) | 2005-04-13 | 2006-10-19 | Trivascular, Inc. | PTFE layers and methods of manufacturing |
US20060259063A1 (en) | 2005-04-25 | 2006-11-16 | Bates Brian L | Wire guides having distal anchoring devices |
US20060247760A1 (en) | 2005-04-29 | 2006-11-02 | Medtronic Vascular, Inc. | Methods and apparatus for treatment of aneurysms adjacent branch arteries |
US20070021819A1 (en) * | 2005-05-23 | 2007-01-25 | Jeff Krolik | Apparatus and Methods for Locating an Ostium of a Vessel |
US20070027522A1 (en) | 2005-06-14 | 2007-02-01 | Chang Jean C | Stent delivery and guidewire systems |
EP1893125B1 (en) | 2005-06-20 | 2018-09-26 | Cook Medical Technologies LLC | Single peel stent introducer apparatus |
WO2007011730A1 (en) * | 2005-07-14 | 2007-01-25 | Cappella Inc. | Delivery system and method of use for deployment of self-expandable vascular device |
WO2007014088A2 (en) | 2005-07-25 | 2007-02-01 | Cook Incorporated | Intraluminal prosthesis and stent |
JP5203192B2 (en) | 2005-07-27 | 2013-06-05 | クック メディカル テクノロジーズ エルエルシー | Stent / graft device and method for placement in open surgery |
EP1915106B1 (en) * | 2005-08-18 | 2018-04-04 | Cook Medical Technologies LLC | Method of manufacturing fenestrated stent grafts |
US20070055358A1 (en) | 2005-08-22 | 2007-03-08 | Krolik Jeffrey A | Axially compressible flared stents and apparatus and methods for delivering them |
US20070050016A1 (en) * | 2005-08-29 | 2007-03-01 | Boston Scientific Scimed, Inc. | Stent with expanding side branch geometry |
DK1942971T3 (en) | 2005-08-31 | 2011-10-17 | Cook Medical Technologies Llc | Catheter for implantation of stents |
US7955374B2 (en) * | 2005-09-02 | 2011-06-07 | Medtronic Vascular, Inc. | Modular branch vessel stent-graft assembly |
US8911491B2 (en) * | 2005-09-02 | 2014-12-16 | Medtronic Vascular, Inc. | Methods and apparatus for treatment of aneurysms adjacent branch arteries including branch artery flow lumen alignment |
US8043366B2 (en) * | 2005-09-08 | 2011-10-25 | Boston Scientific Scimed, Inc. | Overlapping stent |
WO2007035895A2 (en) | 2005-09-21 | 2007-03-29 | Cook Incorporated | Endoluminal stent graft delivery assembly |
US20070067023A1 (en) * | 2005-09-22 | 2007-03-22 | Boston Scientific Scimed, Inc. | Tether guided stent side branch |
US8231669B2 (en) * | 2005-09-22 | 2012-07-31 | Boston Scientific Scimed, Inc. | Tether guided stent side branch |
US7670369B2 (en) | 2005-10-13 | 2010-03-02 | Cook Incorporated | Endoluminal prosthesis |
WO2007051183A1 (en) | 2005-10-28 | 2007-05-03 | Incept, Llc | Flared stents and apparatus and methods for delivering them |
WO2007053592A2 (en) | 2005-10-31 | 2007-05-10 | Cook Incorporated | Composite stent graft |
US20070112420A1 (en) | 2005-11-14 | 2007-05-17 | Duke Fiduciary Llc | Detachable therapeutic tube |
WO2007059280A1 (en) | 2005-11-16 | 2007-05-24 | William A. Cook Australia Pty Ltd | Introducer for implantable device |
US20070149166A1 (en) | 2005-12-23 | 2007-06-28 | Telefonaktiebolaget Lm Ericsson (Publ) | Voice call continuity for emergency calls |
US8778008B2 (en) | 2006-01-13 | 2014-07-15 | Aga Medical Corporation | Intravascular deliverable stent for reinforcement of vascular abnormalities |
US20090069880A1 (en) | 2006-02-03 | 2009-03-12 | Design & Performance - Cyprus Limited | Implantable graft assembly and aneurysm treatment |
WO2007095031A2 (en) | 2006-02-13 | 2007-08-23 | Bay Street Medical, Inc. | System for delivering a stent |
US7914572B2 (en) | 2006-02-13 | 2011-03-29 | William A. Cook Australia Pty. Ltd. | Side branch stent graft construction |
GB0603685D0 (en) | 2006-02-23 | 2006-04-05 | Angiomed Ag | Vascular prosthesis for aneurysms, set of vascular prostheses, method for manufacturing a vascular prosthesis and method for inserting a vascular prosthesis |
JP2007236472A (en) | 2006-03-06 | 2007-09-20 | Terumo Corp | Catheter |
US20070225798A1 (en) | 2006-03-23 | 2007-09-27 | Daniel Gregorich | Side branch stent |
US20070225797A1 (en) * | 2006-03-24 | 2007-09-27 | Medtronic Vascular, Inc. | Prosthesis With Adjustable Opening for Side Branch Access |
US9757260B2 (en) * | 2006-03-30 | 2017-09-12 | Medtronic Vascular, Inc. | Prosthesis with guide lumen |
US9211206B2 (en) | 2006-04-13 | 2015-12-15 | Medtronic Vascular, Inc. | Short handle for a long stent |
US7678141B2 (en) | 2006-04-18 | 2010-03-16 | Medtronic Vascular, Inc. | Stent graft having a flexible, articulable, and axially compressible branch graft |
US20070244547A1 (en) * | 2006-04-18 | 2007-10-18 | Medtronic Vascular, Inc., A Delaware Corporation | Device and Method for Controlling the Positioning of a Stent Graft Fenestration |
US9017361B2 (en) | 2006-04-20 | 2015-04-28 | Covidien Lp | Occlusive implant and methods for hollow anatomical structure |
US8828074B2 (en) | 2006-04-21 | 2014-09-09 | Medtronic Vascular, Inc. | Stent graft having short tube graft for branch vessel |
AU2007255001B2 (en) | 2006-06-02 | 2012-07-26 | Cook Incorporated | Multi-port delivery device |
AU2007258592B2 (en) | 2006-06-06 | 2012-10-25 | Cook Incorporated | Stent with a crush-resistant zone |
US7771465B2 (en) | 2006-06-23 | 2010-08-10 | Gore Enterprise Holdings, Inc. | Branched stent delivery system |
US7824438B2 (en) * | 2006-07-06 | 2010-11-02 | Robert Kipperman | Method for placement of a stent assembly in a bifurcated vessel |
US8029558B2 (en) * | 2006-07-07 | 2011-10-04 | Abbott Cardiovascular Systems, Inc. | Stent and catheter assembly and method for treating bifurcations |
EP2043566B1 (en) | 2006-07-24 | 2010-01-20 | William, a Cook Australia Pty. Ltd. | Medical device introducer with docking arrangement |
US9044350B2 (en) | 2006-08-21 | 2015-06-02 | Boston Scientific Scimed, Inc. | Alignment sheath apparatus and method |
US20080065197A1 (en) * | 2006-09-12 | 2008-03-13 | Boston Scientific Scimed, Inc. | Bifurcated Stent |
US20080071343A1 (en) | 2006-09-15 | 2008-03-20 | Kevin John Mayberry | Multi-segmented graft deployment system |
US8118854B2 (en) * | 2006-09-28 | 2012-02-21 | Cook Medical Technologies Llc | Endovascular delivery device |
US8608790B2 (en) * | 2006-10-06 | 2013-12-17 | Boston Scientific Scimed, Inc. | Bifurcation catheter and method |
JP5109194B2 (en) | 2006-11-07 | 2012-12-26 | ウィリアム・エイ・クック・オーストラリア・プロプライエタリー・リミテッド | Stent graft |
US20080114444A1 (en) * | 2006-11-09 | 2008-05-15 | Chun Ho Yu | Modular stent graft and delivery system |
US7615072B2 (en) | 2006-11-14 | 2009-11-10 | Medtronic Vascular, Inc. | Endoluminal prosthesis |
US20080133000A1 (en) | 2006-12-01 | 2008-06-05 | Medtronic Vascular, Inc. | Bifurcated Stent With Variable Length Branches |
DE102006062360A1 (en) | 2006-12-22 | 2008-06-26 | Aesculap Ag & Co. Kg | Woven artificial organ for an aortic sinus has a first cylindrical section away from a heart, a second cylindrical section with a wider diameter to form a bulbus and a third cylindrical section near to a heart |
DE102006062384A1 (en) | 2006-12-22 | 2008-06-26 | Aesculap Ag & Co. Kg | Tubular vascular prosthesis for replacement of the ascending aorta |
US8216298B2 (en) | 2007-01-05 | 2012-07-10 | Medtronic Vascular, Inc. | Branch vessel graft method and delivery system |
US8523931B2 (en) | 2007-01-12 | 2013-09-03 | Endologix, Inc. | Dual concentric guidewire and methods of bifurcated graft deployment |
US20080172119A1 (en) | 2007-01-12 | 2008-07-17 | Medtronic Vascular, Inc. | Prosthesis Deployment Apparatus and Methods |
US20080188921A1 (en) | 2007-02-02 | 2008-08-07 | Medtronic Vascular, Inc. | Prosthesis Deployment Apparatus and Methods |
US7815601B2 (en) | 2007-02-05 | 2010-10-19 | Boston Scientific Scimed, Inc. | Rapid exchange enteral stent delivery system |
US9526642B2 (en) * | 2007-02-09 | 2016-12-27 | Taheri Laduca Llc | Vascular implants and methods of fabricating the same |
EP2142142B1 (en) | 2007-03-05 | 2017-02-08 | Endospan Ltd | Multi-component expandable supportive bifurcated endoluminal grafts and methods for using same |
US20080294237A1 (en) | 2007-04-04 | 2008-11-27 | Jack Fa-De Chu | Inflatable devices and methods to protect aneurysmal wall |
US8133266B2 (en) | 2007-04-12 | 2012-03-13 | Medtronic Vascular, Inc. | Expandable tip delivery system and method |
US7806917B2 (en) | 2007-04-17 | 2010-10-05 | Medtronic Vascular, Inc. | Stent graft fixation system and method |
US8715336B2 (en) * | 2007-04-19 | 2014-05-06 | Medtronic Vascular, Inc. | Methods and apparatus for treatment of aneurysms adjacent to branch arteries |
US9358142B2 (en) | 2007-04-24 | 2016-06-07 | W. L. Gore & Associates, Inc. | Catheter having guidewire channel |
US8273115B2 (en) | 2007-04-24 | 2012-09-25 | W. L. Gore & Associates, Inc. | Side branched endoluminal prostheses and methods of delivery thereof |
DE102007031148A1 (en) | 2007-06-27 | 2009-01-08 | Aesculap Ag | aortic sinus |
US8048147B2 (en) * | 2007-06-27 | 2011-11-01 | Aga Medical Corporation | Branched stent/graft and method of fabrication |
CA2695679C (en) | 2007-08-08 | 2015-12-01 | Cleveland Clinic Foundation | Branched stent graft system |
US20090088791A1 (en) | 2007-10-02 | 2009-04-02 | Boston Scientific Scimed, Inc. | Carotid System Simplification |
AU2008308474B2 (en) | 2007-10-04 | 2014-07-24 | Trivascular, Inc. | Modular vascular graft for low profile percutaneous delivery |
FR2923008B1 (en) | 2007-10-26 | 2010-01-08 | Thales Sa | METHOD AND DEVICE FOR DISPLAYING FORECASTS ON A NAVIGATION PLAN |
WO2009064806A1 (en) | 2007-11-12 | 2009-05-22 | Endologix, Inc. | Method and agent for in-situ stabilization of vascular tissue |
US20090164001A1 (en) | 2007-12-21 | 2009-06-25 | Biggs David P | Socket For Fenestrated Tubular Prosthesis |
US8221494B2 (en) | 2008-02-22 | 2012-07-17 | Endologix, Inc. | Apparatus and method of placement of a graft or graft system |
US8100960B2 (en) | 2008-03-20 | 2012-01-24 | Medtronic Vascular, Inc. | Bloused stent-graft and fenestration method |
US20090259296A1 (en) | 2008-04-10 | 2009-10-15 | Medtronic Vascular, Inc. | Gate Cannulation Apparatus and Methods |
US8236040B2 (en) | 2008-04-11 | 2012-08-07 | Endologix, Inc. | Bifurcated graft deployment systems and methods |
US20090259290A1 (en) | 2008-04-14 | 2009-10-15 | Medtronic Vascular, Inc. | Fenestration Segment Stent-Graft and Fenestration Method |
US20090264985A1 (en) | 2008-04-17 | 2009-10-22 | Medtronic Vascular, Inc. | Branch Vessel Suture Stent System and Method |
US20090287145A1 (en) | 2008-05-15 | 2009-11-19 | Altura Interventional, Inc. | Devices and methods for treatment of abdominal aortic aneurysms |
JP5134729B2 (en) | 2008-07-01 | 2013-01-30 | エンドロジックス、インク | Catheter system |
WO2010024849A1 (en) | 2008-08-29 | 2010-03-04 | Cook Incorporated | Prosthesis with moveable fenestration |
US20100261662A1 (en) | 2009-04-09 | 2010-10-14 | Endologix, Inc. | Utilization of mural thrombus for local drug delivery into vascular tissue |
EP2429452B1 (en) | 2009-04-28 | 2020-01-15 | Endologix, Inc. | Endoluminal prosthesis system |
US8491646B2 (en) | 2009-07-15 | 2013-07-23 | Endologix, Inc. | Stent graft |
WO2011017123A2 (en) | 2009-07-27 | 2011-02-10 | Endologix, Inc. | Stent graft |
US20120109279A1 (en) | 2010-11-02 | 2012-05-03 | Endologix, Inc. | Apparatus and method of placement of a graft or graft system |
CN105232195B (en) | 2011-03-01 | 2018-06-08 | 恩朵罗杰克斯股份有限公司 | Delivery catheter system |
US9597204B2 (en) * | 2011-12-04 | 2017-03-21 | Endospan Ltd. | Branched stent-graft system |
US20150173932A1 (en) | 2012-08-13 | 2015-06-25 | The United States Of America As Represented By The Secretary Of The Army | Pelvic trauma device |
-
2009
- 2009-02-20 US US12/390,346 patent/US8221494B2/en active Active
- 2009-02-20 WO PCT/US2009/034755 patent/WO2009105699A1/en active Application Filing
-
2012
- 2012-07-11 US US13/546,950 patent/US8672989B2/en active Active
-
2014
- 2014-02-04 US US14/172,126 patent/US9149381B2/en not_active Expired - Fee Related
-
2015
- 2015-08-31 US US14/840,428 patent/US20150366688A1/en not_active Abandoned
-
2017
- 2017-05-31 US US15/610,242 patent/US10245166B2/en active Active
-
2019
- 2019-03-22 US US16/361,777 patent/US20190216623A1/en not_active Abandoned
-
2021
- 2021-03-15 US US17/201,995 patent/US20210196491A1/en active Pending
Patent Citations (4)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US20070299497A1 (en) * | 1998-12-11 | 2007-12-27 | Endologix, Inc. | Implantable vascular graft |
US20020147491A1 (en) * | 1999-11-22 | 2002-10-10 | Khan I. John | Stent delivery system having a fixed guidewire |
US20060155358A1 (en) * | 2005-01-10 | 2006-07-13 | Laduca Robert | Methods for placing a stent in a branched vessel |
US20070260304A1 (en) * | 2006-05-02 | 2007-11-08 | Daniel Gregorich | Bifurcated stent with minimally circumferentially projected side branch |
Cited By (20)
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US9149381B2 (en) | 2008-02-22 | 2015-10-06 | Endologix, Inc. | Apparatus and method of placement of a graft or graft system |
US10603196B2 (en) | 2009-04-28 | 2020-03-31 | Endologix, Inc. | Fenestrated prosthesis |
US11406518B2 (en) | 2010-11-02 | 2022-08-09 | Endologix Llc | Apparatus and method of placement of a graft or graft system |
WO2012061526A3 (en) * | 2010-11-02 | 2012-08-23 | Endologix, Inc. | Apparatus and method of placement of a graft or graft system |
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US11129737B2 (en) | 2015-06-30 | 2021-09-28 | Endologix Llc | Locking assembly for coupling guidewire to delivery system |
Also Published As
Publication number | Publication date |
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US20120277846A1 (en) | 2012-11-01 |
US8672989B2 (en) | 2014-03-18 |
US20090216315A1 (en) | 2009-08-27 |
US10245166B2 (en) | 2019-04-02 |
US20190216623A1 (en) | 2019-07-18 |
US8221494B2 (en) | 2012-07-17 |
US20210196491A1 (en) | 2021-07-01 |
US20150366688A1 (en) | 2015-12-24 |
US20170266025A1 (en) | 2017-09-21 |
US20140249615A1 (en) | 2014-09-04 |
US9149381B2 (en) | 2015-10-06 |
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