Debranching visceral stent graft and methods for use

• US 10,350,052 B2
• Filed: 08/29/2016
• Issued: 07/16/2019
• Est. Priority Date: 04/12/2012
• Status: Active Grant

• Current Assignee: Sanford Health-Meritcare (MeritCare Health System)
• Original Assignee: Sanford Health-Meritcare (MeritCare Health System)
• Inventors: Kelly, Patrick W
• Primary Examiner(s): Sharma, Yashita
• Assistant Examiner(s): Preston, Rebecca S
• Application Number:
  US15/250,583
• Publication Number:
  US 20160367353A1
• Time in Patent Office: 1,051 Days
• CPC Class Codes: A61F 2/07 Stent-grafts
• CPC Class Codes: A61F 2/848 having means for fixation to the vessel wall, e.g. barbs
• CPC Class Codes: A61F 2/852 Two or more distinct overlapping stents
• CPC Class Codes: A61F 2/856 Single tubular stent with a side portal passage
• CPC Class Codes: A61F 2/95 Instruments specially adapted for placement or removal of stents or stent-grafts
• CPC Class Codes: A61F 2/9522 Means for mounting a stent or stent-graft onto or into a placement instrument
• CPC Class Codes: A61F 2/954 for placing stents or stent-grafts in a bifurcation
• CPC Class Codes: A61F 2002/061 provided with means for allowing access to secondary lumens
• CPC Class Codes: A61F 2002/065 Y-shaped blood vessels
• CPC Class Codes: A61F 2002/067 modular
• CPC Class Codes: A61F 2002/072 Encapsulated stents, e.g. wire or whole stent embedded in lining
• CPC Class Codes: A61F 2002/075 the stent being loosely attached to the graft material, e.g. by stitching
• CPC Class Codes: A61F 2002/826 more than one stent being applied sequentially
• CPC Class Codes: A61F 2002/828 Means for connecting a plurality of stents allowing flexibility of the whole structure
• CPC Class Codes: A61F 2220/0025 Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
• CPC Class Codes: A61F 2220/005 using adhesives
• CPC Class Codes: A61F 2220/0058 soldered or brazed or welded
• CPC Class Codes: A61F 2220/0075 sutured, ligatured or stitched, retained or tied with a rope, string, thread, wire or cable
• CPC Class Codes: A61F 2230/001 Figure-8-shaped, e.g. hourglass-shaped
• CPC Class Codes: A61F 2230/006 Y-shaped
• CPC Class Codes: A61F 2250/006 : modular
• CPC Class Codes: A61F 2250/0062 : Kits of prosthetic parts to be assembled in various combinations for forming different prostheses
• CPC Class Codes: A61F 2250/0098 : radio-opaque, e.g. radio-opaque markers

Abstract

A visceral double-barreled main body stent graft and methods for its use, the stent graft comprises, a main body stent graft having distal and proximal ends, the main body stent graft'"'"'s length ranges from about 100-120 mm and diameter at the proximal end ranges from about 30-45 mm, first and second lumens defined at the main body stent graft'"'"'s distal end, the first lumen'"'"'s diameter ranges from about 18-20 mm, the second lumen'"'"'s diameter ranges from about 16-18 mm, the first and second lumens have about the same length from about 50-70 mm, the first lumen is secured to the second lumen along a shared length, and the main body stent graft defines a tubular wall that is contiguous with the first and second lumens such that any fluid entering the main body must exit through one of the first or second lumens.

Claims

1. A debranching stent graft comprising:

a main body stent graft with a first bifurcation defining a first leg and a second leg, wherein the main body stent graft has a distal end and a proximal end;

wherein the main body stent graft has an as-deployed diameter at the proximal end in the range from about 18 mm to about 22 mm;

wherein the second leg is at least about 10 mm longer than the first leg; and

a first visceral limb coupled to the first leg in a unitary configuration, wherein the first visceral limb has a second bifurcation defining a third leg and a fourth leg, wherein the first visceral limb has a length in the range from about 30 mm to about 50 mm; and

a second visceral limb coupled to the second leg in a unitary configuration, wherein the second visceral limb has a third bifurcation defining a fifth leg and a sixth leg.

2. The debranching stent graft of claim 1, wherein the second bifurcation occurs immediately at a proximal end of the first visceral limb.

3. The debranching stent graft of claim 1, wherein the second visceral limb has a length in the range from about 30 mm to about 50 mm.

4. The debranching stent graft of claim 1, wherein each of the fifth leg and the sixth leg have a diameter of about 7 mm.

5. The debranching stent graft of claim 1, wherein the second visceral limb has a length in the range from about 30 mm to about 50 mm.

6. The debranching stent graft of claim 1, wherein the second leg is no more than about 20 mm longer than the first leg.

7. The debranching stent graft of claim 1, wherein the first leg and the second leg each have a diameter in the range from about 14 mm to about 16 mm and wherein the first visceral limb has a diameter at a proximal end that ranges from about 14 mm to about 16 mm.

8. The debranching stent graft of claim 1, wherein the as-deployed diameter of the main body stent graft at the proximal end is about 22 mm.

9. The debranching stent graft of claim 1, wherein the distance from the proximal end of the main body stent graft to a distal end of the first leg is in the range from about 70 mm to about 90 mm;

and wherein the distance from the proximal end of the main body stent graft to a distal end of the second leg is in the range from about 80 mm to about 100 mm.

10. The debranching stent graft of claim 1, wherein the first bifurcation occurs in the range from about 30 mm to about 40 mm from the proximal end.

11. A debranching stent graft comprising:

a main body stent graft with a first bifurcation defining a first leg and a second leg, wherein the main body stent graft has a distal end and a proximal end;

wherein the main body stent graft has an as-deployed diameter at the proximal end in the range from about 18 mm to about 22 mm;

wherein the second leg is at least about 10 mm longer than the first leg; and

a first visceral limb coupled to the first leg in a unitary configuration, wherein the first visceral limb has a second bifurcation defining a third leg and a fourth leg, wherein each of the third leg and the fourth leg have a diameter of about 7 mm.

12. A debranching stent graft comprising:

a main body stent graft with a first bifurcation defining a first leg and a second leg, wherein the main body stent graft has a distal end and a proximal end;

wherein the main body stent graft has an as-deployed diameter at the proximal end in the range from about 18 mm to about 22 mm;

wherein the second leg is at least about 10 mm longer than the first leg; and

a first visceral limb coupled to the first leg in a unitary configuration, wherein the first visceral limb has a second bifurcation defining a third leg and a fourth leg; and

a second visceral limb coupled to the second leg in a unitary configuration, wherein the second visceral limb has a third bifurcation defining a fifth leg and a sixth leg, wherein the second bifurcation occurs immediately at a proximal end of the first visceral limb and wherein the third bifurcation occurs immediately at a proximal end of the second visceral limb.

13. The debranching stent graft of claim 12, wherein the second visceral limb has a length in the range from about 30 mm to about 50 mm.

17. A method for placement of a debranching stent graft, the method comprising:

introducing a guidewire into an aorta via arterial access;

loading a delivery catheter containing the debranching stent graft according to claim 12 onto the guidewire;

moving the delivery catheter along the guidewire and introducing the delivery catheter into the aorta via arterial access; and

deploying the debranching stent graft into one of the aorta or a lumen of a previously-placed stent graft within the aorta.

14. A method for placement of a debranching stent graft, the method comprising:

introducing a guidewire into an aorta via arterial access;

loading a delivery catheter containing the debranching stent graft onto the guidewire;

wherein the debranching stent graft comprises;

a main body stent graft with a first bifurcation defining a first leg and a second leg, wherein the main body stent graft has a distal end and a proximal end;

wherein the main body stent graft has an as-deployed diameter at the proximal end in the range from about 18 mm to about 22 mm;

wherein the second leg is at least about 10 mm longer than the first leg; and

a first visceral limb coupled to the first leg in a unitary configuration, wherein the first visceral limb has a second bifurcation defining a third and fourth leg, wherein the first visceral limb has a length in the range from about 30 mm to about 50 mm; and

a second visceral limb coupled to the second leg in a unitary configuration, wherein the second visceral limb has a third bifurcation defining a fifth leg and a sixth leg.

15. A method for placement of a debranching stent graft, the method comprising:

introducing a guidewire into an aorta via arterial access;

loading a delivery catheter containing the debranching stent graft onto the guidewire;

wherein the debranching stent graft comprises;

a main body stent graft with a first bifurcation defining a first leg and a second leg, wherein the main body stent graft has a distal end and a proximal end;

wherein the main body stent graft has an as-deployed diameter at the proximal end in the range from about 18 mm to about 22 mm;

wherein the second leg is at least about 10 mm longer than the first leg; and

a first visceral limb coupled to the first leg in a unitary configuration, wherein the first visceral limb has a second bifurcation defining a third leg and a fourth leg, wherein each of the third leg and the fourth leg have a diameter of about 7 mm.

16. The method of claim 15, further comprising:

introducing a second guidewire into the aorta via arterial access;

loading a second delivery catheter containing a second visceral limb onto the second guidewire;

moving the second delivery catheter along the second guidewire and introducing the second delivery catheter into the second leg of the debranching stent graft via arterial access; and

deploying a proximal end of the second visceral limb into the second leg of the debranching stent graft.