WO2007022495A1 - Design and assembly of fenestrated stent grafts - Google Patents
Design and assembly of fenestrated stent grafts Download PDFInfo
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- WO2007022495A1 WO2007022495A1 PCT/US2006/032562 US2006032562W WO2007022495A1 WO 2007022495 A1 WO2007022495 A1 WO 2007022495A1 US 2006032562 W US2006032562 W US 2006032562W WO 2007022495 A1 WO2007022495 A1 WO 2007022495A1
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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
- A61F2/02—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
-
- 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
- A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/86—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure
- A61F2/89—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure the wire-like elements comprising two or more adjacent rings flexibly connected by separate members
-
- 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
- A61F2/02—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
- A61F2002/061—Blood vessels provided with means for allowing access to secondary lumens
-
- 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
- A61F2/02—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
- A61F2002/065—Y-shaped blood vessels
-
- 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
- A61F2/02—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
- A61F2002/075—Stent-grafts the stent being loosely attached to the graft material, e.g. by stitching
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- 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
- A61F2002/9505—Instruments specially adapted for placement or removal of stents or stent-grafts having retaining means other than an outer sleeve, e.g. male-female connector between stent and instrument
-
- 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
- A61F2002/9505—Instruments specially adapted for placement or removal of stents or stent-grafts having retaining means other than an outer sleeve, e.g. male-female connector between stent and instrument
- A61F2002/9511—Instruments specially adapted for placement or removal of stents or stent-grafts having retaining means other than an outer sleeve, e.g. male-female connector between stent and instrument the retaining means being filaments or wires
-
- 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
- A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2230/0002—Two-dimensional shapes, e.g. cross-sections
- A61F2230/0028—Shapes in the form of latin or greek characters
- A61F2230/005—Rosette-shaped, e.g. star-shaped
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- A—HUMAN NECESSITIES
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- 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
- A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2230/0002—Two-dimensional shapes, e.g. cross-sections
- A61F2230/0028—Shapes in the form of latin or greek characters
- A61F2230/0054—V-shaped
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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
- A61F2230/00—Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2230/0063—Three-dimensional shapes
- A61F2230/0067—Three-dimensional shapes conical
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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
- A61F2250/00—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2250/0014—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis
- A61F2250/0039—Special features of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof having different values of a given property or geometrical feature, e.g. mechanical property or material property, at different locations within the same prosthesis differing in diameter
Definitions
- This invention relates to pre-operative sizing and assembly of a stent graft for deployment and to a stent graft with fenestrations.
- distal with respect to a portion of the aorta, a deployment device or a prosthesis is the end of the aorta, deployment device or prosthesis further away in the direction of blood flow away from the heart and the term proximal means the portion of the aorta, deployment device or end of the prosthesis nearer to the heart.
- stent grafts for placement into the thoracoabdominal aorta for the treatment of aneurysms and more specifically in relation to juxtarenal placement. They are not, however, so restricted and may be applied to stent grafts for placement in any lumen of the human or animal body.
- the segment of aorta between the celiac and renal arteries is the best endowed with adventitial elastin, the most stable, and the last to dilate.
- Aneurysms of this area are associated with aneurysms of less stable areas in the descending thoracic aorta, infrarenal aorta, or both.
- Surgical repair of the thoracoabdominal aorta often involves wide exposure through long, multi-cavity incisions, followed by periods of visceral ischemia.
- the mortality and morbidity rates remain high, especially in patients who are old, sick, or have already undergone open surgical repair of an adjacent segment of the aorta.
- a barbed uncovered Z-stent anchors the proximal end, and a single proximal orifice attaches to a non-dilated segment of aorta (or previously inserted prosthesis). They all distribute blood through multiple branches, cuffs or holes (fenestrations), and they have series of Z-stents and Nitinol rings, providing support from one end of the stent-graft to the other.
- Properly positioned fenestrations provide a route for flow through the stent-graft into the renal arteries, thereby allowing the proximal end of the stent-graft to be placed higher in the non-dilated pararenal aorta where it assumes a cylindrical shape.
- the dual goals of renal perfusion and aneurysm exclusion are achieved only when the fenestration is positioned precisely over the renal orifices, and the outer surface of the stent-graft around the fenestration is brought into close apposition with the v inner surface of the aorta around the renal orifice.
- a typical fenestrated technique uses a bridging catheter, sheath or balloon to guide each fenestration to the corresponding renal orifice, and a bridging stent to hold it there.
- Stent-graft deployment has five main stages: extrusion of the half-open stent-graft, trans- graft renal artery catheterization, complete stent-graft expansion, renal stenting, and completion of the aortic exclusion with bifurcated extension into the iliac arteries.
- the three forms of fenestration in common use are the large fenestration, the scallop and the small fenestration.
- a large fenestration is used only when the target artery is well away from the aneurysm.
- a scallop is essentially a large open-topped fenestration.
- the presence of a scallop for the superior mesenteric artery allows sufficient separation ( > 15mm) between proximal margin of the stent-graft and the middle of the renal orifices.
- Small fenestrations are commonly placed over both renal arteries, and held there by bridging stents. Stent struts cannot cross the orifice of a small fenestration. Small fenestrations are therefore confined to the lower halves of the triangular spaces between adjacent stent-struts.
- Localized juxtarenal aneurysms or pseudo-aneurysms require no more than a single cylindrical fenestrated stent-graft, but most cases of infrarenal aneurysm extend to the aortic bifurcation and require bilateral iliac outflow through a bifurcated stent-graft.
- the combination of a fenestrated proximal component with a bifurcated distal component is called a composite stent graft. Dividing the stent-graft into two components separates the two halves of the procedure.
- the operator need not be concerned about the position or orientation of the bifurcation while inserting the fenestrated proximal component, or about the position and location of the fenestrations while inserting the bifurcated distal component.
- the composite arrangement also separates the fenestrated proximal component from the large caudally directed hemodynamic forces that act mainly upon the bifurcation of the distal component. A small amount of slippage between the two is preferable to any proximal component migration, where even a few millimetres of movement would occlude both renal arteries. Indeed, the low rate of renal artery loss is testimony to the accuracy of stent-graft deployment and the stability of stent-graft attachment. The positioning of the fenestration is therefore very important to avoid renal occlusion.
- the present invention seeks to provide an improved method of manufacturing a stent graft and to an improved stent graft.
- the selected datum position on the vessel is the anterior-most point in the vessel.
- the internal diameter of the body vessel and the angular position of each of the side branches can be determined for instance with the use of narrow slice, contrast enhanced computer tomography.
- the step of reducing the diameter can comprise applying diameter reducing ties.
- the step of applying diameter reducing ties can comprise the steps of: a) extending a release wire longitudinally along the stent graft; b) looping a flexible thread around the release wire and extending one end of the flexible thread laterally around the circumference of the stent graft to a position a selected distance from the release wire; c) engaging the flexible thread into the graft material, and d) drawing the ends of the thread together and tying ends of the thread, whereby the selected distance is reduced thereby reducing the overall diameter of the stent graft.
- the step of applying diameter reducing ties can also comprise the steps of; e) passing a second flexible thread around the release wire or the first flexible thread and extending the second flexible thread laterally around the circumference of the stent graft in the opposite direction to the first flexible thread to a position a selected distance from the release wire; f) engaging the second flexible thread into the graft material, and g) drawing the ends of the second thread together and tying ends of the thread, whereby the selected distance is reduced thereby reducing the overall diameter of the stent graft.
- the circumferential thread extends circumferentially in each direction from the release wire.
- the step of applying diameter reducing ties can comprise applying a plurality of diameter reducing ties along the length of the stent graft.
- the invention also encompasses a stent graft prepared by the method taught herein.
- a stent graft as specified in claim 17.
- the stent graft can further comprise a plurality of diameter reducing ties temporarily reducing the diameter, the diameter reducing ties being substantially diametrically opposed to the graft datum point.
- the stent graft can further comprise a temporary diameter reduction constraint arrangement at a position substantially diametrically opposed to the graft datum point, the constraint arrangement comprising at least one release wire extending longitudinally along the tubular body and at least one circumferential thread engaged around the release wire and a portion of the stent graft circumferentially spaced a selected distance away from the release wire and drawn tight and tied to reduce the circumference and hence the overall diameter of the stent graft.
- a fenestrated stent-graft which is a highly customized device, which has a design based largely upon the findings of narrow slice, contrast-enhanced CT, and the expected orientation of the stent-graft.
- each arterial orifice can be located relative to other landmarks up and down the long axis of the aorta, and oriented relative to other points on the same trans-axial section of the aorta. The orientation is described as an angle or as hours and minutes, as though the aorta were a clock face with anterior being 12:00.
- the preferred embodiments provide for pre-operative sizing and placement of the fenestrations on a stent graft and the assembly of a stent graft onto a deployment device.
- Some embodiments described herein also address the problem of assembly or mounting onto a deployment device to assist with accurate release upon deployment.
- Figure 1 shows a schematic view of an aneurysed aorta with a bifurcated and fenestrated stent graft deployed into it
- Figure 2 shows a schematic cross section of the aorta in the renal arteries and shows how the position of the renal arteries with respect to a datum position is determined using a clock face system
- Figure 3 shows a similar embodiment to that of Figure 2 except using a method determining the position using angles from a selected datum
- Figure 4 shows a similar view to that of Figures 2 and 3 but with a stent graft in a semi- contracted condition deployed in the aorta but not showing other features of the deployment device upon which the stent graft is deployed;
- Figure 5 shows a similar view to that of Figure 4 except with the diameter reducing ties on the stent graft released;
- Figure 6 shows a similar view of Figure 5 with side graft stents placed in the fenestrations
- Figures 7 A and 7B show schematically how one arrangement of a diameter reducing tie is applied to a stent graft;
- Figures 8A and 8B show an alternative embodiment of diameter reducing tie intended for use with a stent graft;
- Figures 9A, 9B and 9C show a stent graft in various stages of application and release of double diameter reducing ties on a stent graft.
- Detailed Description Referring to Figure 1 there is schematically shown an aorta 2 extending down to an aortic bifurcation at 3 and into two iliac arteries 5 and 7.
- An aneurysm 9 defined by a bulge in the aorta wall 1 1 extends from near to the aortic bifurcation 3 nearly to the renal arteries 13 and 15.
- This embodiment provides a bifurcated stent graft having a longer leg for extending into one iliac artery and a shorter leg into which a leg extension may be deployed for the contralateral iliac artery but the teachings herein are not so limited and may also be used for a composite stent graft in which the fenestrations are in a proximal tubular portion of the composite stent graft and if necessary a further bifurcated portion of stent graft is used to extend down to the iliac arteries.
- stent graft 20 has a proximally extending exposed stent 22, a proximal internal stent 36 and a plurality of external stents 38 along the length of its tubular body.
- the stent graft 20 has a bifurcation 24 and a long leg 27 extending down iliac artery 7and a short leg 26 directed towards iliac artery 5.
- a leg extension 28 is connected into the short leg 26 and extends down the iliac artery 5.
- the stent graft 20 has a proximal internal stent 36 and a plurality of external stents 38 along the length of its tubular body.
- fenestrations 30 and 32 for allowing access to the renal arteries and it is to the placement of these renal fenestrations on the stent graft so that they match up with the renal arteries when the stent graft is deployed into the aorta that the teachings herein are directed.
- Methods of mounting a stent graft onto a deployment device and deployment of such a stent graft are described in WO-98/53761 , the features of which could be used with the teachings herein.
- renal arteries in Figure 1 are depicted as extending laterally either side of the aorta, in fact the position of the renal arteries is very variable and they are sometimes closer together towards the anterior surface of the aorta and can be positioned more or less apart longitudinally.
- Figures 2 and 3 show a schematic cross-section of the aorta in the region of the renal arteries indicated by the arrow 35 in Figure 1 .
- the aorta 2 has an aorta wall 1 1 , while renal arteries 13 and 1 5 extend therefrom.
- the renal arteries are depicted as being at the same level in the aorta, although generally there may be a longitudinal spacing between the left and right renal arteries, as is depicted in Figure 1 .
- a stent graft placed into an aorta has a diameter of perhaps 10 to 20 percent more than the diameter of the aorta and hence if the angular position of the fenestrations, one with respect the to other, were translated from the renal artery to the larger diameter stent graft and the stent graft released into the aorta, it is unlikely that it could be possible to ensure easily that the fenestrations open in apposition to the respective renal arteries because it is not possible to guarantee that the stent graft will open evenly within the aorta.
- the cross-section of the aorta in the region of the renal arteries as shown in Figure 2 is obtained by radio-graphic techniques such as narrow slice enhanced computer tomography.
- a datum point 40 on the aorta is selected. This is normally taken as the anterior point on the aorta as this can be most easily ascertained from radiography during deployment.
- the position of the renal arteries with respect to the datum point 40 is then determined.
- the method used is to assume that the aorta at the level of the renal arteries comprises a clock face with 12 o'clock at the selected datum point 40. This means that the centre of the renal artery 13 is at approximately 2 o 'clock and the centre of the renal artery 1 5 is at approximately 10:30.
- FIG 3 another arrangement is used, in which degrees either side of the datum point 40 are used.
- the renal artery 13 is at approximately 65 degrees from the datum point 40 to one side and the other renal artery 1 5 is approximately 40 degrees on the other side of the datum point.
- the inner circumference of the wall of the aorta is calculated and the circumferential distance 42 from the datum point 40 to the centre of the renal artery 13 and the circumferential distance 44 from the datum point 40 to the centre of the renal artery 1 5 is calculated.
- a stent graft is then selected with a diameter which is 10 to 20 percent greater than the diameter of the aorta 2. For instance if the aorta has a diameter of 30 millimetres at the level of the renal arteries then a stent graft may be selected with a diameter of 36 millimetres at that level.
- a datum point 41 see
- Figure 4 which corresponds to the position, when the stent graft is deployed, of the selected datum point 40 on the aorta, is then selected on the stent graft and the circumferential distances 42 and 44 are measured on the surface of the stent graft in each direction from the datum point 41 to define centre points for each fenestration. Fenestrations are then positioned around those centre points. It will be realised that a certain amount of latitude may be provided to ensure the fenestrations do not interfere with struts of stents on the surface of the stent graft.
- Diameter reducing ties are then applied to the stent graft as will be discussed in more detail with respect to Figures 7, 8 and 9. For clarity the various components of the deployment device are not depicted in Figures 4, 5 and 6.
- a stent graft has been partially deployed into the aorta 2 with a sheath (not shown) retracted but the diameter reducing ties generally shown as 50 are still in place so that the overall diameter of the stent graft 52 is somewhat less that the diameter of the aorta 2.
- the stent graft can be rotated and moved longitudinally.
- the stent graft is rotationally positioned so that the datum point 41 on the stent graft is coincident with the selected datum point 40 on the aorta.
- Observations of the position of the stent graft in the aorta can be made because radio opaque markers on the stent graft can be observed by suitable radiographic techniques.
- Fenestrations 54 and 56 have been placed so that the distance 57 of the fenestration 54 from the datum point 41 and the distance 58 of the fenestration 56 to the datum point 41 are the same as the distances 42 and 44 respectively as discussed in relation to Figure 2.
- the diameter reducing ties are held in place by a release wire 60. It will be noted that the diameter reducing ties are as far as possible diametrically opposed to the two fenestrations 54 and 56 so that the diameter reduced portion 62 of the stent graft 52 is as far around from the renal arteries as possible.
- the actual positions of the fenestrations 54 and 56 are shown by radio opaque markers 63 either side of the fenestrations 54, 56.
- the release wire has been withdrawn so that the diameter reducing ties 50 are released and the stent graft can engage the walls of the aorta.
- the corrugated portion of the stent graft which was involved with the temporary diameter reduction does not fully expand so that the circumferential distance between the fenestrations is equivalent to the circumferential distance of the wall of the aorta between the fenestrations and access to the renal arteries through the fenestrations is possible.
- Figure 6 depicts a subsequent stage in the deployment process, where balloon expanded stents 66 and 68 have been deployed through the fenestrations 54, 56 and into the renal arteries 13 and 15, respectively, and expanded.
- Figures 7A and 7B show schematically one embodiment of diameter reducing tie.
- the graft material of a stent graft is not shown and only a portion of a self-expanding stent is shown stretched out flat.
- FIG 7A a self-expanding stent 70 which would extend around the tubular body of a stent graft and be stitched to the stent graft material is shown.
- a release wire 72 is stitched longitudinally along the stent graft, shown in more detail in Figure 9A, with a stitch 72a being exposed to the outside of the stent graft in the region of the self-expanding stent 70.
- a first suture thread 74 is passed around the release wire 72 and extended out to one side of the release wire over the struts 76 of the stent graft to pass over three struts and to be looped around a fourth strut and into the graft material.
- the suture thread 74 is then pulled tight and knotted as shown in Figure 7B with a knot 78, so that the struts between the release wire 72 and the knot 78 are pulled closer together.
- a similar action is carried out to the other side of the release wire with a thread 80.
- the thread 80 can either pass around the release wire 72 or is passed underneath the two strands of the thread 74 and over the release wire 72, passed over three struts and then it can be passed over three struts and looped around a fourth strut and into the graft material and pulled tight and knotted at 82.
- the reduction in distance between the release wire 72 and the knot 78 may be from 50 to 75 percent. For instance if the distance is 1 5 millimetres round the circumference from the release wire 72 to the strut at which the knot 78 is placed, then this can be reduced to 5 millimetres. With two diameter reducing ties one to each side of the release wire 72, a total circumference reduction of 20 millimetres can be achieved which will change the diameter of a 36 millimetre stent graft to approximately 28 millimetres.
- this is less than the diameter of the aorta, which means that the stent graft will still be manoeuvrable within the aorta while still mounted onto the deployment device but partially freed by the withdrawal of a containing sheath.
- double diameter reducing ties may be used, as depicted in Figures 8A and 8B.
- two release wires 90 and 92 are used, parallel to each other and spaced by 6 or 7 struts of a self-expanding stent 91 .
- the two release wires 90 and 92 are stitched longitudinally along the stent graft, shown in more detail in Figure 9A, with stitches 90a and 92a being exposed to the outside of the stent graft in the region of the self-expanding stent 91 .
- a first suture 93 extends from one side of the release wire 90 and a second suture 94 extends to the other side of the release wire 90 and they are knotted off at 95 and 96.
- sutures 97 and 98 are extended either side of the release wire 92 and are knotted off at 99 and 100.
- the knots 96 and 99 go on either side of the same strut.
- Figures 9A, 9B and 9C show a stent graft with various stages of fitting and release of diameter reducing ties.
- Figure 9A shows a more proximal portion of a composite stent graft for mounting into the aorta.
- the stent graft includes a tubular body 120 with an intemal zigzag self-expanding stent 122 at its proximal end and an exposed proximally extending stent 124 mounted to the proximal end of the tubular body 120.
- tubular body 120 tapers at 130 so that it has a first selected diameter at the proximal end and a slightly smaller diameter further down the length of the tubular body.
- the first stage is the placement of release wires 132 and 134 which extend longitudinally along the tubular body and are stitched in and out of the tubular body. Stitches can be seen on the exterior of the tubular body in regions coinciding with the intermediate region of each of the exposed stents.
- a suture is placed around the release wire, extended across about three struts of the zigzag stent 126 to strut 136 and pulled tight, as shown at 138 in Figure 9B.
- a suture 140 is extended from the other direction from the release wire 132 for about three struts and then pulled tight.
- a similar extension of sutures in each direction from release wire 134 is installed to compress the other side.
- the suture 142 which extends back towards the release wire 132 is joined to the same strut 136 as the suture 138.
- the suture 144 extends in the opposite direction from the release wire 134.
- FIG. 9B shows the stent graft mounted onto a deployment device with a pusher catheter 1 50 at one end and a nose cone capsule 152 into which the proximally extending stent 124 is received at the other end.
- Figure 9C shows the stent graft still mounted onto the deployment device so that the exposed stent 124 is still received in the capsule 152 but the release wires have been withdrawn so that the diameter reducing ties are released.
- the sutures 140, 138, 142, and 144 remain on the outside of the stent graft. This is not a problem as they do not interfere with blood flow and may assist with adhesion of the stent graft onto the wall of the aorta.
- two sets of double diameter reducing ties may be used with one set of such ties and trigger wire placed anteriorily to the renal arteries and another set of such ties and trigger wire placed posteriorily to the renal arteries.
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- Health & Medical Sciences (AREA)
- Gastroenterology & Hepatology (AREA)
- Pulmonology (AREA)
- Cardiology (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Transplantation (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Vascular Medicine (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Prostheses (AREA)
Abstract
Description
Claims
Priority Applications (4)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
CA2619585A CA2619585C (en) | 2005-08-18 | 2006-08-18 | Design and assembly of fenestrated stent grafts |
AU2006279305A AU2006279305B2 (en) | 2005-08-18 | 2006-08-18 | Design and assembly of fenestrated stent grafts |
JP2008527206A JP5156936B2 (en) | 2005-08-18 | 2006-08-18 | A fenestration stent graft and its sizing method |
EP06801982.7A EP1915106B1 (en) | 2005-08-18 | 2006-08-18 | Method of manufacturing fenestrated stent grafts |
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US70941105P | 2005-08-18 | 2005-08-18 | |
US60/709,411 | 2005-08-18 |
Publications (1)
Publication Number | Publication Date |
---|---|
WO2007022495A1 true WO2007022495A1 (en) | 2007-02-22 |
Family
ID=37500179
Family Applications (2)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/US2006/032562 WO2007022495A1 (en) | 2005-08-18 | 2006-08-18 | Design and assembly of fenestrated stent grafts |
PCT/US2006/032683 WO2007022526A1 (en) | 2005-08-18 | 2006-08-18 | Assembly of stent grafts |
Family Applications After (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/US2006/032683 WO2007022526A1 (en) | 2005-08-18 | 2006-08-18 | Assembly of stent grafts |
Country Status (6)
Country | Link |
---|---|
US (2) | US9504555B2 (en) |
EP (3) | EP1915106B1 (en) |
JP (1) | JP5156936B2 (en) |
AU (2) | AU2006279305B2 (en) |
CA (2) | CA2619587C (en) |
WO (2) | WO2007022495A1 (en) |
Cited By (14)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
WO2008140796A1 (en) | 2007-05-11 | 2008-11-20 | William A. Cook Australia Pty. Ltd. | Stent grafts for the thoracic aorta |
WO2009055723A2 (en) | 2007-10-24 | 2009-04-30 | Cordis Corporation | Stent segments axially connected by thin film |
US8172895B2 (en) | 2005-08-18 | 2012-05-08 | Cook Medical Technologies Llc | Design and assembly of fenestrated stent grafts |
US8956397B2 (en) | 2009-12-31 | 2015-02-17 | Endospan Ltd. | Endovascular flow direction indicator |
US8979892B2 (en) | 2009-07-09 | 2015-03-17 | Endospan Ltd. | Apparatus for closure of a lumen and methods of using the same |
US9101457B2 (en) | 2009-12-08 | 2015-08-11 | Endospan Ltd. | Endovascular stent-graft system with fenestrated and crossing stent-grafts |
US9427339B2 (en) | 2011-10-30 | 2016-08-30 | Endospan Ltd. | Triple-collar stent-graft |
EP3115022A1 (en) | 2015-07-10 | 2017-01-11 | Ptmc Institute | Stent-graft |
US9597204B2 (en) | 2011-12-04 | 2017-03-21 | Endospan Ltd. | Branched stent-graft system |
US9770350B2 (en) | 2012-05-15 | 2017-09-26 | Endospan Ltd. | Stent-graft with fixation elements that are radially confined for delivery |
US9839510B2 (en) | 2011-08-28 | 2017-12-12 | Endospan Ltd. | Stent-grafts with post-deployment variable radial displacement |
US9918825B2 (en) | 2009-06-23 | 2018-03-20 | Endospan Ltd. | Vascular prosthesis for treating aneurysms |
US10485684B2 (en) | 2014-12-18 | 2019-11-26 | Endospan Ltd. | Endovascular stent-graft with fatigue-resistant lateral tube |
US10603197B2 (en) | 2013-11-19 | 2020-03-31 | Endospan Ltd. | Stent system with radial-expansion locking |
Families Citing this family (139)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US7147661B2 (en) | 2001-12-20 | 2006-12-12 | Boston Scientific Santa Rosa Corp. | Radially expandable stent |
US7314484B2 (en) * | 2002-07-02 | 2008-01-01 | The Foundry, Inc. | Methods and devices for treating aneurysms |
US11890181B2 (en) * | 2002-07-22 | 2024-02-06 | Tmt Systems, Inc. | Percutaneous endovascular apparatus for repair of aneurysms and arterial blockages |
US8425549B2 (en) | 2002-07-23 | 2013-04-23 | Reverse Medical Corporation | Systems and methods for removing obstructive matter from body lumens and treating vascular defects |
US9125733B2 (en) | 2003-01-14 | 2015-09-08 | The Cleveland Clinic Foundation | Branched vessel endoluminal device |
US9707113B2 (en) * | 2006-04-19 | 2017-07-18 | Cook Medical Technologies Llc | Twin bifurcated stent graft |
EP2066270B1 (en) * | 2006-09-28 | 2011-09-07 | Med Institute, Inc. | Endovascular delivery device |
WO2008053469A2 (en) * | 2006-10-29 | 2008-05-08 | Alon Shalev | An extra-vascular wrapping for treating aneurysmatic aorta and methods thereof |
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US9717584B2 (en) | 2007-04-13 | 2017-08-01 | W. L. Gore & Associates, Inc. | Medical apparatus and method of making the same |
US9642693B2 (en) | 2007-04-13 | 2017-05-09 | W. L. Gore & Associates, Inc. | Medical apparatus and method of making the same |
US20080255678A1 (en) * | 2007-04-13 | 2008-10-16 | Cully Edward H | Medical apparatus and method of making the same |
US11337714B2 (en) | 2007-10-17 | 2022-05-24 | Covidien Lp | Restoring blood flow and clot removal during acute ischemic stroke |
US9198687B2 (en) * | 2007-10-17 | 2015-12-01 | Covidien Lp | Acute stroke revascularization/recanalization systems processes and products thereby |
US9220522B2 (en) | 2007-10-17 | 2015-12-29 | Covidien Lp | Embolus removal systems with baskets |
US8066757B2 (en) | 2007-10-17 | 2011-11-29 | Mindframe, Inc. | Blood flow restoration and thrombus management methods |
US8926680B2 (en) | 2007-11-12 | 2015-01-06 | Covidien Lp | Aneurysm neck bridging processes with revascularization systems methods and products thereby |
US8585713B2 (en) | 2007-10-17 | 2013-11-19 | Covidien Lp | Expandable tip assembly for thrombus management |
US8088140B2 (en) | 2008-05-19 | 2012-01-03 | Mindframe, Inc. | Blood flow restorative and embolus removal methods |
US10123803B2 (en) | 2007-10-17 | 2018-11-13 | Covidien Lp | Methods of managing neurovascular obstructions |
CN101965162B (en) | 2007-12-15 | 2014-12-10 | 恩多斯潘有限公司 | Extra-vascular wrapping for treating aneurysmatic aorta in conjunction with endovascular stent-graft and methods thereof |
GB2475494B (en) * | 2009-11-18 | 2011-11-23 | Cook William Europ | Stent graft and introducer assembly |
US9180030B2 (en) | 2007-12-26 | 2015-11-10 | Cook Medical Technologies Llc | Low profile non-symmetrical stent |
US9226813B2 (en) | 2007-12-26 | 2016-01-05 | Cook Medical Technologies Llc | Low profile non-symmetrical stent |
US8574284B2 (en) | 2007-12-26 | 2013-11-05 | Cook Medical Technologies Llc | Low profile non-symmetrical bare alignment stents with graft |
GB2476451A (en) * | 2009-11-19 | 2011-06-29 | Cook William Europ | Stent Graft |
WO2009089297A2 (en) * | 2008-01-07 | 2009-07-16 | Intersect Partners, Llc | Novel enhanced ptna rapid exchange type of catheter system |
WO2009105699A1 (en) | 2008-02-22 | 2009-08-27 | Endologix, Inc. | Design and method of placement of a graft or graft system |
US8940003B2 (en) | 2008-02-22 | 2015-01-27 | Covidien Lp | Methods and apparatus for flow restoration |
US20090264989A1 (en) | 2008-02-28 | 2009-10-22 | Philipp Bonhoeffer | Prosthetic heart valve systems |
US20090248131A1 (en) * | 2008-03-31 | 2009-10-01 | Medtronic Vascular, Inc. | Covered Stent and Method of Making Same |
EP2262444B1 (en) * | 2008-04-09 | 2018-02-28 | Cook Medical Technologies LLC | Stent-graft |
EP2271390A4 (en) * | 2008-04-11 | 2016-07-20 | Covidien Lp | Monorail neuro-microcatheter for delivery of medical devices to treat stroke, processes and products thereby |
US8128686B2 (en) * | 2008-04-18 | 2012-03-06 | Cook Medical Technologies Llc | Branched vessel prosthesis |
US10028747B2 (en) | 2008-05-01 | 2018-07-24 | Aneuclose Llc | Coils with a series of proximally-and-distally-connected loops for occluding a cerebral aneurysm |
US10716573B2 (en) | 2008-05-01 | 2020-07-21 | Aneuclose | Janjua aneurysm net with a resilient neck-bridging portion for occluding a cerebral aneurysm |
US20100305686A1 (en) * | 2008-05-15 | 2010-12-02 | Cragg Andrew H | Low-profile modular abdominal aortic aneurysm graft |
US20100049294A1 (en) | 2008-06-04 | 2010-02-25 | Zukowski Stanislaw L | Controlled deployable medical device and method of making the same |
CA2725736C (en) | 2008-06-04 | 2013-09-17 | Gore Enterprise Holdings, Inc. | Controlled deployable medical device and method of making the same |
US20100076470A1 (en) * | 2008-09-22 | 2010-03-25 | Tyco Healthcare Group Lp | Methods and Devices for Sheath Compression |
US8137398B2 (en) * | 2008-10-13 | 2012-03-20 | Medtronic Ventor Technologies Ltd | Prosthetic valve having tapered tip when compressed for delivery |
GB2464978B (en) * | 2008-10-31 | 2010-10-20 | Cook William Europ | Introducer for deploying a stent graft in a curved lumen |
AU2009200350B1 (en) | 2009-02-02 | 2009-07-16 | Cook Incorporated | Preloaded stent graft delivery device |
US20100274276A1 (en) * | 2009-04-22 | 2010-10-28 | Ricky Chow | Aneurysm treatment system, device and method |
EP2429452B1 (en) | 2009-04-28 | 2020-01-15 | Endologix, Inc. | Endoluminal prosthesis system |
US9358140B1 (en) | 2009-11-18 | 2016-06-07 | Aneuclose Llc | Stent with outer member to embolize an aneurysm |
US9757263B2 (en) * | 2009-11-18 | 2017-09-12 | Cook Medical Technologies Llc | Stent graft and introducer assembly |
EP2506797A4 (en) * | 2009-11-30 | 2016-10-19 | Biflow Medical Ltd | Method of implanting a stent graft and creating a fenestration therein |
US9358099B2 (en) | 2009-11-30 | 2016-06-07 | Biflow Medical Ltd. | Method of implanting a stent graft and creating a fenestration therein |
EP2506810B1 (en) | 2009-11-30 | 2020-07-08 | Endospan Ltd | Multi-component stent-graft system for implantation in a blood vessel with multiple branches |
ES2577853T3 (en) | 2009-12-01 | 2016-07-19 | Altura Medical, Inc. | Modular endograft devices |
US9468517B2 (en) | 2010-02-08 | 2016-10-18 | Endospan Ltd. | Thermal energy application for prevention and management of endoleaks in stent-grafts |
AU2010201676B1 (en) | 2010-04-23 | 2010-07-22 | Cook Medical Technologies Llc | Curve forming stent graft |
US8894700B2 (en) * | 2010-05-31 | 2014-11-25 | Po-Jen Ko | Abdominal aortic stent |
AU2010202487B1 (en) | 2010-06-15 | 2011-07-28 | Cook Incorporated | Pre-loaded multiport delivery device |
US9101455B2 (en) | 2010-08-13 | 2015-08-11 | Cook Medical Technologies Llc | Preloaded wire for endoluminal device |
CA2747610C (en) | 2010-08-13 | 2014-09-16 | Cook Medical Technologies Llc | Precannulated fenestration |
WO2012040240A1 (en) | 2010-09-20 | 2012-03-29 | Altura Medical, Inc. | Stent graft delivery systems and associated methods |
EP2635241B1 (en) | 2010-11-02 | 2019-02-20 | Endologix, Inc. | Apparatus for placement of a graft or graft system |
US9566149B2 (en) * | 2010-11-16 | 2017-02-14 | W. L. Gore & Associates, Inc. | Devices and methods for in situ fenestration of a stent-graft at the site of a branch vessel |
AU2010254599B1 (en) | 2010-12-15 | 2011-02-17 | Cook Incorporated | Hybrid Type A dissection device |
US9198787B2 (en) * | 2010-12-31 | 2015-12-01 | Cook Medical Technologies Llc | Conformable prosthesis delivery system and method for deployment thereof |
CA2826022A1 (en) | 2011-02-03 | 2012-08-09 | Endospan Ltd. | Implantable medical devices constructed of shape memory material |
US9855046B2 (en) | 2011-02-17 | 2018-01-02 | Endospan Ltd. | Vascular bands and delivery systems therefor |
EP2680788A4 (en) | 2011-03-02 | 2014-12-10 | Endospan Ltd | Reduced-strain extra- vascular ring for treating aortic aneurysm |
EP2517671B1 (en) | 2011-04-28 | 2016-05-11 | Cook Medical Technologies LLC | Apparatus for facilitating deployment of an endoluminal prosthesis |
US9119743B2 (en) * | 2011-06-03 | 2015-09-01 | Cook Medical Technologies Llc | Introducer for deploying an implant |
US8574287B2 (en) | 2011-06-14 | 2013-11-05 | Endospan Ltd. | Stents incorporating a plurality of strain-distribution locations |
WO2012176187A1 (en) | 2011-06-21 | 2012-12-27 | Endospan Ltd. | Endovascular system with circumferentially-overlapping stent-grafts |
EP2729095B1 (en) | 2011-07-07 | 2016-10-26 | Endospan Ltd. | Stent fixation with reduced plastic deformation |
US8728148B2 (en) | 2011-11-09 | 2014-05-20 | Cook Medical Technologies Llc | Diameter reducing tie arrangement for endoluminal prosthesis |
EP2775958B1 (en) | 2011-11-11 | 2017-01-04 | Bolton Medical, Inc. | Universal endovascular grafts |
CN106420107B (en) | 2011-11-16 | 2019-02-05 | 波顿医疗公司 | The device and method of reparation for aortic branch blood vessel |
US20130166015A1 (en) | 2011-12-22 | 2013-06-27 | Cook Medical Technologies Llc | Hybrid aortic arch replacement |
EP2985007B1 (en) | 2011-12-22 | 2019-11-13 | Cook Medical Technologies LLC | Preloaded wire for endoluminal device |
DE102012101103B3 (en) | 2012-02-10 | 2013-07-04 | Jotec Gmbh | Stentgraft with fixation elements and insertion system |
US9402755B2 (en) * | 2012-03-13 | 2016-08-02 | W. L. Gore & Associates, Inc. | Sleeve retraction system |
US8968384B2 (en) * | 2012-04-27 | 2015-03-03 | Medtronic Vascular, Inc. | Circumferentially constraining sutures for a stent-graft |
WO2014026173A1 (en) | 2012-08-10 | 2014-02-13 | Cragg Andrew H | Stent delivery systems and associated methods |
AU2012258394B1 (en) * | 2012-11-27 | 2013-03-07 | Cook Medical Technologies Llc | Stent graft having a closeable fenestration |
AU2012258395B1 (en) | 2012-11-27 | 2013-03-28 | Cook Medical Technologies Llc | Assembly of stent grafts with diameter reducing ties |
EP2745813A1 (en) | 2012-12-18 | 2014-06-25 | Cook Medical Technologies LLC | Preloaded wire for endoluminal device |
US10039657B2 (en) * | 2012-12-21 | 2018-08-07 | CARDINAL HEALTH SWITZERLAND 515 GmbH | Cannulation guiding device for bifurcated stent and method of use |
US10350096B2 (en) * | 2012-12-26 | 2019-07-16 | Cook Medical Technologies Llc | Expandable stent-graft system having diameter reducing connectors |
US10154918B2 (en) * | 2012-12-28 | 2018-12-18 | Cook Medical Technologies Llc | Endoluminal prosthesis with fiber matrix |
WO2014108895A2 (en) | 2013-01-08 | 2014-07-17 | Endospan Ltd. | Minimization of stent-graft migration during implantation |
US9668892B2 (en) | 2013-03-11 | 2017-06-06 | Endospan Ltd. | Multi-component stent-graft system for aortic dissections |
GB2511775A (en) * | 2013-03-12 | 2014-09-17 | Cook Medical Technologies Llc | Device and Method for Treating Vascular Dissections |
US9545324B2 (en) | 2013-03-13 | 2017-01-17 | Cook Medical Technologies Llc | Pre-loaded iliac branch device and methods of deployment |
WO2014144809A1 (en) | 2013-03-15 | 2014-09-18 | Altura Medical, Inc. | Endograft device delivery systems and associated methods |
DE102013004625A1 (en) | 2013-03-16 | 2014-09-18 | Universitätsklinikum Freiburg | Bioresorbable stent |
ES2690839T3 (en) | 2013-06-05 | 2018-11-22 | Aortic Innovations Surena, Llc | Sets of variable depression stents (VDS) and undulating grafts |
AU2013206465B1 (en) | 2013-06-18 | 2014-01-16 | Cook Medical Technologies Llc | Endovascular graft with an expanded lumen at a bifurcation |
AU2013206712B1 (en) | 2013-07-03 | 2013-11-28 | Cook Medical Technologies Llc | Endovascular graft having a cannulation pocket |
US20150119975A1 (en) * | 2013-10-24 | 2015-04-30 | The Cleveland Clinic Foundation | Branched vessel prosthesis for repair of a failed stent graft |
EP3539507B1 (en) | 2014-09-23 | 2023-11-22 | Bolton Medical, Inc. | Vascular repair devices |
EP3037072B1 (en) | 2014-12-23 | 2020-04-22 | Cook Medical Technologies LLC | Introducer with side opening |
US10092428B2 (en) | 2014-12-30 | 2018-10-09 | Cook Medical Technologies Llc | Low profile prosthesis delivery device |
CN107405206A (en) * | 2015-01-14 | 2017-11-28 | 库克医学技术有限责任公司 | Suture wire rack mount deployment system |
JP6436572B2 (en) * | 2015-03-13 | 2018-12-12 | テルモ株式会社 | Medical device |
WO2017004265A1 (en) | 2015-06-30 | 2017-01-05 | Endologix, Inc. | Locking assembly for coupling guidewire to delivery system |
US10034785B1 (en) | 2015-10-13 | 2018-07-31 | W. L. Gore & Associates, Inc. | Single site access aortic aneurysm repair method |
US10188538B2 (en) | 2015-12-30 | 2019-01-29 | Cook Medical Technologies Llc | Hybrid trigger wire for endografts |
US10610393B2 (en) | 2016-03-24 | 2020-04-07 | Cook Medical Technologies Llc | Wire retention and release mechanisms |
EP3439583B1 (en) | 2016-04-05 | 2020-09-09 | Bolton Medical, Inc. | Stent graft with internal tunnels and fenestrations |
ES2905193T3 (en) | 2016-05-25 | 2022-04-07 | Bolton Medical Inc | Stent grafts for the treatment of aneurysms |
EP3468505B1 (en) | 2016-06-13 | 2021-02-24 | Aortica Corporation | Systems and devices for marking and/or reinforcing fenestrations in prosthetic implants |
US20180021155A1 (en) | 2016-07-21 | 2018-01-25 | Cook Medical Technologies Llc | Tapered body aaa graft |
EP3493766B1 (en) | 2016-08-02 | 2024-03-06 | Bolton Medical, Inc. | Assembly for coupling a prosthetic implant to a fenestrated body |
US10772751B2 (en) | 2016-09-09 | 2020-09-15 | Cook Medical Technologies Llc | Fenestrated endoluminal prosthesis and system and method of deployment thereof |
EP3320881B1 (en) | 2016-11-10 | 2019-09-04 | Cook Medical Technologies LLC | Diameter reduction constraint arrangement for a stent graft in combination with a stent graft |
US11191632B2 (en) | 2016-11-10 | 2021-12-07 | Cook Medical Technologies Llc | Temporary diameter reduction constraint arrangement for a stent graft in combination with a stent graft |
US10433993B2 (en) | 2017-01-20 | 2019-10-08 | Medtronic Vascular, Inc. | Valve prosthesis having a radially-expandable sleeve integrated thereon for delivery and prevention of paravalvular leakage |
JP7112393B2 (en) | 2017-02-24 | 2022-08-03 | ボルトン メディカル インコーポレイテッド | Stent graft delivery system with retracted sheath and method of use |
JP7065091B2 (en) | 2017-02-24 | 2022-05-11 | ボルトン メディカル インコーポレイテッド | Radially adjustable stent graft delivery system |
EP3534837A1 (en) | 2017-02-24 | 2019-09-11 | Bolton Medical, Inc. | Constrainable stent graft, delivery system and methods of use |
ES2935516T3 (en) | 2017-02-24 | 2023-03-07 | Bolton Medical Inc | Delivery system for radially constraining a stent graft |
WO2018156847A1 (en) | 2017-02-24 | 2018-08-30 | Bolton Medical, Inc. | Delivery system and method to radially constrict a stent graft |
WO2018156848A1 (en) | 2017-02-24 | 2018-08-30 | Bolton Medical, Inc. | Vascular prosthesis with crimped adapter and methods of use |
WO2018156851A1 (en) | 2017-02-24 | 2018-08-30 | Bolton Medical, Inc. | Vascular prosthesis with moveable fenestration |
EP3838220A1 (en) | 2017-02-24 | 2021-06-23 | Bolton Medical, Inc. | System to radially constrict a stent graft |
WO2018156849A1 (en) | 2017-02-24 | 2018-08-30 | Bolton Medical, Inc. | Vascular prosthesis with fenestration ring and methods of use |
WO2018156850A1 (en) | 2017-02-24 | 2018-08-30 | Bolton Medical, Inc. | Stent graft with fenestration lock |
US10709541B2 (en) | 2017-04-28 | 2020-07-14 | Cook Medical Technologies Llc | Systems and methods for adjusting the diameter of an endoluminal prosthesis and an endoluminal prosthesis configured for the same |
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 |
WO2019089071A1 (en) * | 2017-10-31 | 2019-05-09 | Bolton Medical, Inc. | Distal torque component, delivery system and method of using same |
US11096810B2 (en) | 2017-11-29 | 2021-08-24 | Cook Medical Technologies Llc | Preloaded pusher tip for endografts |
JP7090156B2 (en) * | 2017-12-01 | 2022-06-23 | シー・アール・バード・インコーポレーテッド | Artificial medical device |
EP3494936A1 (en) | 2017-12-05 | 2019-06-12 | Cook Medical Technologies LLC | Endograft delivery device assembly |
CN109984862A (en) * | 2017-12-29 | 2019-07-09 | 杭州唯强医疗科技有限公司 | A kind of aorta tectorial membrane stent that can be discharged step by step |
EP3508172B1 (en) | 2018-01-03 | 2020-08-19 | Cook Medical Technologies LLC | Pre-loaded multiport delivery device |
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EP4302727A3 (en) * | 2018-12-18 | 2024-04-17 | Lifetech Scientific (Shenzhen) Co., Ltd. | Lumen stent and implant |
WO2020157037A1 (en) | 2019-01-29 | 2020-08-06 | Aggion Gmbh | Vascular prosthesis for treating an aneurysm, in particular an aortic aneurysm |
US11166833B2 (en) | 2019-04-30 | 2021-11-09 | Cook Medical Technologies Llc | Line pull assembly for a prosthetic delivery device |
DE102019121930A1 (en) * | 2019-08-14 | 2021-02-18 | Jotec Gmbh | Vascular prosthesis |
GB2605559B (en) | 2021-01-07 | 2023-04-05 | Cook Medical Technologies Llc | Stent graft |
CN113274166B (en) * | 2021-05-10 | 2023-12-08 | 杭州唯强医疗科技有限公司 | Tectorial membrane support and conveying system |
Citations (7)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
WO1999029262A1 (en) | 1997-12-10 | 1999-06-17 | William A. Cook Australia Pty. Ltd. | Endoluminal aortic stents |
WO2001001864A1 (en) * | 1999-07-02 | 2001-01-11 | The Cleveland Clinic Foundation | Intravascular ultrasonic analysis using active contour method and system |
WO2004019823A1 (en) * | 2002-09-02 | 2004-03-11 | Cook Incorporated | Branch grafting device and method |
US20040054280A1 (en) * | 2002-09-18 | 2004-03-18 | Mcmorrow Gerald J. | Three-dimensional system for abdominal aortic aneurysm evaluation |
EP1405613A1 (en) * | 2002-10-04 | 2004-04-07 | SORIN BIOMEDICA CARDIO S.p.A. | An implant device for treating aneurisms of the abdominal aorta |
US20040171932A1 (en) * | 2002-11-27 | 2004-09-02 | Raghav Raman | Quantification of aortoiliac endoluminal irregularity |
WO2006007389A1 (en) * | 2004-06-16 | 2006-01-19 | Cook Incorprated | Thoracic deployment device and stent graft |
Family Cites Families (29)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5693083A (en) * | 1983-12-09 | 1997-12-02 | Endovascular Technologies, Inc. | Thoracic graft and delivery catheter |
CH678393A5 (en) * | 1989-01-26 | 1991-09-13 | Ulrich Prof Dr Med Sigwart | |
US5387235A (en) * | 1991-10-25 | 1995-02-07 | Cook Incorporated | Expandable transluminal graft prosthesis for repair of aneurysm |
US5456713A (en) * | 1991-10-25 | 1995-10-10 | Cook Incorporated | Expandable transluminal graft prosthesis for repairs of aneurysm and method for implanting |
AU669338B2 (en) * | 1991-10-25 | 1996-06-06 | Cook Incorporated | Expandable transluminal graft prosthesis for repair of aneurysm and method for implanting |
US5587728A (en) | 1994-04-29 | 1996-12-24 | International Business Machines Corporation | Optical feedback printer |
US6015429A (en) * | 1994-09-08 | 2000-01-18 | Gore Enterprise Holdings, Inc. | Procedures for introducing stents and stent-grafts |
WO1996036297A1 (en) * | 1995-05-19 | 1996-11-21 | Kanji Inoue | Transplantation instrument, method of bending same and method of transplanting same |
US6929659B2 (en) * | 1995-11-07 | 2005-08-16 | Scimed Life Systems, Inc. | Method of preventing the dislodgment of a stent-graft |
US6042605A (en) * | 1995-12-14 | 2000-03-28 | Gore Enterprose Holdings, Inc. | Kink resistant stent-graft |
ATE290832T1 (en) * | 1996-01-05 | 2005-04-15 | Medtronic Inc | EXPANDABLE ENDOLUMINAL PROSTHESES |
US6878161B2 (en) * | 1996-01-05 | 2005-04-12 | Medtronic Vascular, Inc. | Stent graft loading and deployment device and method |
US5843158A (en) * | 1996-01-05 | 1998-12-01 | Medtronic, Inc. | Limited expansion endoluminal prostheses and methods for their use |
US6551350B1 (en) * | 1996-12-23 | 2003-04-22 | Gore Enterprise Holdings, Inc. | Kink resistant bifurcated prosthesis |
US6352561B1 (en) * | 1996-12-23 | 2002-03-05 | W. L. Gore & Associates | Implant deployment apparatus |
AUPO700897A0 (en) | 1997-05-26 | 1997-06-19 | William A Cook Australia Pty Ltd | A method and means of deploying a graft |
US5984955A (en) * | 1997-09-11 | 1999-11-16 | Wisselink; Willem | System and method for endoluminal grafting of bifurcated or branched vessels |
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 |
US6350277B1 (en) * | 1999-01-15 | 2002-02-26 | Scimed Life Systems, Inc. | Stents with temporary retaining bands |
US7018401B1 (en) * | 1999-02-01 | 2006-03-28 | Board Of Regents, The University Of Texas System | Woven intravascular devices and methods for making the same and apparatus for delivery of the same |
US6287333B1 (en) * | 1999-03-15 | 2001-09-11 | Angiodynamics, Inc. | Flexible stent |
JP4138144B2 (en) * | 1999-03-31 | 2008-08-20 | テルモ株式会社 | Intraluminal indwelling |
JP2001186326A (en) * | 1999-12-27 | 2001-07-06 | Ricoh Co Ltd | Method for embedding picture forgery verifying data, method and device for verifying forgery of picture and recording medium |
US20020193872A1 (en) * | 2001-06-18 | 2002-12-19 | Trout Hugh H. | Prosthetic graft assembly and method of use |
AUPR847301A0 (en) * | 2001-10-26 | 2001-11-15 | Cook Incorporated | Endoluminal prostheses for curved lumens |
MXPA05001845A (en) * | 2002-08-15 | 2005-11-17 | Gmp Cardiac Care Inc | Stent-graft with rails. |
WO2007022495A1 (en) | 2005-08-18 | 2007-02-22 | William A. Cook Australia Pty. Ltd. | Design and assembly of fenestrated stent grafts |
US8377113B2 (en) * | 2007-05-11 | 2013-02-19 | William A. Cook Austraila Pty. Ltd. | Stent grafts for the thoracic aorta |
AU2010201676B1 (en) * | 2010-04-23 | 2010-07-22 | Cook Medical Technologies Llc | Curve forming stent graft |
-
2006
- 2006-08-18 WO PCT/US2006/032562 patent/WO2007022495A1/en active Application Filing
- 2006-08-18 EP EP06801982.7A patent/EP1915106B1/en active Active
- 2006-08-18 CA CA2619587A patent/CA2619587C/en active Active
- 2006-08-18 WO PCT/US2006/032683 patent/WO2007022526A1/en active Application Filing
- 2006-08-18 AU AU2006279305A patent/AU2006279305B2/en active Active
- 2006-08-18 US US11/507,115 patent/US9504555B2/en active Active
- 2006-08-18 AU AU2006280948A patent/AU2006280948B2/en active Active
- 2006-08-18 EP EP06813626.6A patent/EP1922029B1/en active Active
- 2006-08-18 EP EP12171060.2A patent/EP2497444B1/en active Active
- 2006-08-18 JP JP2008527206A patent/JP5156936B2/en active Active
- 2006-08-18 US US11/507,247 patent/US8172895B2/en active Active
- 2006-08-18 CA CA2619585A patent/CA2619585C/en active Active
Patent Citations (7)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
WO1999029262A1 (en) | 1997-12-10 | 1999-06-17 | William A. Cook Australia Pty. Ltd. | Endoluminal aortic stents |
WO2001001864A1 (en) * | 1999-07-02 | 2001-01-11 | The Cleveland Clinic Foundation | Intravascular ultrasonic analysis using active contour method and system |
WO2004019823A1 (en) * | 2002-09-02 | 2004-03-11 | Cook Incorporated | Branch grafting device and method |
US20040054280A1 (en) * | 2002-09-18 | 2004-03-18 | Mcmorrow Gerald J. | Three-dimensional system for abdominal aortic aneurysm evaluation |
EP1405613A1 (en) * | 2002-10-04 | 2004-04-07 | SORIN BIOMEDICA CARDIO S.p.A. | An implant device for treating aneurisms of the abdominal aorta |
US20040171932A1 (en) * | 2002-11-27 | 2004-09-02 | Raghav Raman | Quantification of aortoiliac endoluminal irregularity |
WO2006007389A1 (en) * | 2004-06-16 | 2006-01-19 | Cook Incorprated | Thoracic deployment device and stent graft |
Cited By (27)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
EP2497444A1 (en) | 2005-08-18 | 2012-09-12 | William A. Cook Australia Pty. Ltd. | Design and assembly of fenestrated stent grafts |
US8172895B2 (en) | 2005-08-18 | 2012-05-08 | Cook Medical Technologies Llc | Design and assembly of fenestrated stent grafts |
WO2008140796A1 (en) | 2007-05-11 | 2008-11-20 | William A. Cook Australia Pty. Ltd. | Stent grafts for the thoracic aorta |
JP2010526586A (en) * | 2007-05-11 | 2010-08-05 | 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 | Thoracic aorta stent graft |
US8603156B2 (en) | 2007-05-11 | 2013-12-10 | Cook Medical Technologies Llc | Stent grafts for the thoracic aorta |
US8597346B2 (en) | 2007-05-11 | 2013-12-03 | Cook Medical Technologies Llc | Stent grafts for the thoracic aorta |
US8377113B2 (en) | 2007-05-11 | 2013-02-19 | William A. Cook Austraila Pty. Ltd. | Stent grafts for the thoracic aorta |
US8906085B2 (en) | 2007-10-24 | 2014-12-09 | Cordis Corporation | Stent segments axially connected by thin film |
US8142490B2 (en) | 2007-10-24 | 2012-03-27 | Cordis Corporation | Stent segments axially connected by thin film |
US8142491B2 (en) | 2007-10-24 | 2012-03-27 | Cordis Corporation | Stent segments axially connected by thin film |
WO2009055723A3 (en) * | 2007-10-24 | 2010-08-26 | Cordis Corporation | Stent segments axially connected by thin film |
AU2008316617B2 (en) * | 2007-10-24 | 2013-12-19 | Advanced Bio Prosthetic Surfaces Ltd. | Stent segments axially connected by thin film |
WO2009055723A2 (en) | 2007-10-24 | 2009-04-30 | Cordis Corporation | Stent segments axially connected by thin film |
US11090148B2 (en) | 2009-06-23 | 2021-08-17 | Endospan Ltd. | Vascular prosthesis for treating aneurysms |
US9918825B2 (en) | 2009-06-23 | 2018-03-20 | Endospan Ltd. | Vascular prosthesis for treating aneurysms |
US8979892B2 (en) | 2009-07-09 | 2015-03-17 | Endospan Ltd. | Apparatus for closure of a lumen and methods of using the same |
US9101457B2 (en) | 2009-12-08 | 2015-08-11 | Endospan Ltd. | Endovascular stent-graft system with fenestrated and crossing stent-grafts |
US8956397B2 (en) | 2009-12-31 | 2015-02-17 | Endospan Ltd. | Endovascular flow direction indicator |
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 |
US9770350B2 (en) | 2012-05-15 | 2017-09-26 | Endospan Ltd. | Stent-graft with fixation elements that are radially confined for delivery |
US10603197B2 (en) | 2013-11-19 | 2020-03-31 | Endospan Ltd. | Stent system with radial-expansion locking |
US10485684B2 (en) | 2014-12-18 | 2019-11-26 | Endospan Ltd. | Endovascular stent-graft with fatigue-resistant lateral tube |
US11419742B2 (en) | 2014-12-18 | 2022-08-23 | Endospan Ltd. | Endovascular stent-graft with fatigue-resistant lateral tube |
EP3115022A1 (en) | 2015-07-10 | 2017-01-11 | Ptmc Institute | Stent-graft |
US10695163B2 (en) | 2015-07-10 | 2020-06-30 | Ptmc Institute | Stent-graft |
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EP2497444A1 (en) | 2012-09-12 |
AU2006279305B2 (en) | 2011-07-21 |
CA2619587A1 (en) | 2007-02-22 |
EP1915106A1 (en) | 2008-04-30 |
JP2009504349A (en) | 2009-02-05 |
CA2619585A1 (en) | 2007-02-22 |
CA2619587C (en) | 2014-06-10 |
US8172895B2 (en) | 2012-05-08 |
EP2497444B1 (en) | 2015-09-16 |
JP5267124B2 (en) | 2013-08-21 |
AU2006280948A1 (en) | 2007-02-22 |
JP2009504352A (en) | 2009-02-05 |
AU2006279305A1 (en) | 2007-02-22 |
EP1922029B1 (en) | 2014-11-19 |
US9504555B2 (en) | 2016-11-29 |
EP1922029A1 (en) | 2008-05-21 |
JP5156936B2 (en) | 2013-03-06 |
CA2619585C (en) | 2014-04-29 |
US20070043425A1 (en) | 2007-02-22 |
EP1915106B1 (en) | 2018-04-04 |
US20070142896A1 (en) | 2007-06-21 |
WO2007022526A1 (en) | 2007-02-22 |
AU2006280948B2 (en) | 2011-10-27 |
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